summary: Facility Evaluation

raw_content:
Narrative:
On 12/04/25 at 8:30AM Licensing Program Analyst (LPA) Wendely Moodie-Naranjo made an unannounced visit to Evolve Treatment Aura facility for the purpose of conducting an Annual/Random Required Inspection visit. LPA met with Kiana Ayati, Residential Counselor, who granted access to the facility and Romeo Eta, Operations Manager and together a tour of the facility was conducted. This facility is licensed to provide care and supervision to six (6) ambulatory clients, ages 12-17 years old. The census is six (6) clients. General overview: This is a 4 bedroom (2 single occupancy, and 2 dual occupancy), 8 bathrooms, elegantly furnished two-story home with a one program director's office, one staff office (which was converted from the Master Bedroom, and located on the 2nd floor), 1 therapist office located in the home, and 1 therapist office located in a detached guest house in the backyard near the pool, a living room/recreational room, dining room, kitchen, family room/Group room, garage (used as a gym, and art room), laundry area, and a large entertainer's backyard. There are 23 facility cameras on the premises, and an approved Camera Waiver on file. There are no firearms or dangerous weapons in the home. Medicines are inaccessible to children. All smoke detectors were tested and are operating properly in the home at the time of visit. Carbon Monoxide alarms were observed and functional in the home at the time of the visit. There are numerous fully charged fire extinguishers available. Outdoor activity space free of obstructions. Water temperature measured within safe temperatures. First aid kits were checked and complete with scissors, tweezers, thermometer, gauzes, antiseptic and 1st Aid Manual. All posting requirements for the Licensee's Foster Care License have been met. The Group Home license and personal rights posting were observed by the entrance , to the left of the door. There are covered fireplaces in the home where the key for the gas are kept with the maintenance personnel. Report to cont... on LIC 809-C page Continued from LIC809 page 1 1st Floor: The first level of the home includes the following: 1/2 bathroom: immediately adjacent to the front door entrance and observed to be clean and in good repair. Laundry area: equipped with a washer and dryer, the electrical panel, a fully charged fire extinguisher, facility vehicle's cleaning supplies, emergency food supply(dehydrated food), a camera and plenty of cabinet/storage space. Therapist office: equipped with a full bathroom, desk, computer, couch, chair, and closet in good repair. Garage/Gym/Art Room: locked except when in use, converted from a four (4) car garage spaces, equipped with plenty of locked cabinets for storage, carbon monoxide detector, phone, fire extinguisher, exercise equipment, camera, table with seven (7) chairs and art supplies, a refrigerator/freezer, and a wall that closes off the water heater and exit door to the backyard. This exit door to the backyard is locked and accessible only through the backyard by staff only. Living Room/Recreational Room: with a securely covered fireplace with plenty of seating, a foosball table, a TV and phone accessible to clients during phone time. School area: converted from the home's dining room to be used for school purposes, and equipped with a fully charged fire extinguisher, six (6) desks and chairs, and four (4) computers, a phone, a fire extinguisher and a camera. Program Director's Office: locked for authorized staff only, and equipped with a phone, a printer, a sitting area with views to the backyard, a door that has direct access to a locked Nurse's station. Nurse's station: adjacent to and direct access from the Program Director's office, and the kitchen. The station was converted from the "Butler's Pantry". It is equipped with plenty of cabinet space (some with locks) , first-aid kit, medical supplies, over-the-counter medication, and six(6) small locked boxes were observed to keep each clients individual medication. Kitchen: equipped with a refrigerator/freezer, dual oven, a functional 5-burner gas range stove, and plenty of cabinet space. Knives/Sharp objects are stored in the staff office and logged out by the chef. Chemicals and cleaning solutions are kept in locked cabinets under the sink. Another sink is observed in the kitchen island, where a non-functional electric 2-burner stove is stationed as well. A microwave, two (2) dishwashers (one functional and one not functioning), toaster oven, and coffee pot and small kitchen appliances were also observed. A weekly menu was posted in the kitchen. The perishable and non-perishable foods were fully stocked with supply for at least 2 days of perishable foods, as well as 7 days of non-perishable foods on hand. Report to cont..on LIC 809-C page Breakfast/Dining area: equipped with a round table with seven (7) chairs, and bay windows, a camera and a door that exits to patio. Second Floor: All bedrooms are upstairs Bedrooms Bedroom #1: Occupied by two (2) clients,C1 and C2; the bedroom is equipped two (2) twin sized beds, comfortable mattresses, with one (1) closet, and one (1) bathroom. Bedroom #2: Occupied by two (2) clients,C3 and C4; the bedroom is equipped two (2) twin sized beds, one (1) closet, and one (1) bathroom. Bedroom #3: Occupied by one (1) client, C5; the bedroom is equipped with one (1) twin sized bed, comfortable mattresses, and one (1) closet, and one (1) bathroom. Bedroom #4: Occupied by one (1) client,C6; the bedroom is equipped with one (1) twin sized beds, and one (1) walk in closet, and one (1) bathroom. All bedrooms have adequate lighting, adequate drawers, closet space, and lighting in the room. Elevator: non-functional or operational, observed to be empty, locked, and equipped with a gate and a disconnected phone. OM stated they have never used the elevator. Bathrooms: Each of the bedrooms have a full bathroom. Bathroom #5: Is located to the right once entering the facility. This bathroom is only used by clients. Bathroom #6: Is located inside therapy room #1. Bathroom #7: Is located inside the staff office upstairs (Used by staff only) Bathroom #8 is located inside therapy room #2 outside in the guest house.(Used by staff only) The Exterior consists of the following: POOL: Located in the backyard, with a five-foot fence with a self-latching lock meeting required standards and regulations. The backyard also contains a: tennis court with one basketball hoop; an area which will be used as a garden; a grassy area with 2 gazebos; a large detached guess house building used as a therapy office equipped with a fully charged fire extinguisher, covered fireplace, smoke alarm, carbon monoxide detector, phone, desk, couch, chair, electrical panel, and 3/4 bathroom. The front yard also had a drained waterfall emptying into a pond, which has been filled with dirt and used as a garden. There are no deficiencies to be cited at this time. Exit interview was conducted and a copy of this report will be emailed to the Facility Administrator (FA).


state: CA

facility_name: EVOLVE TREATMENT, AURA

summary: Facility Evaluation

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Narrative:
On 01/08/24 at 09: Licensing Program Analyst (LPA) Jhane Haynes made an unannounced visit to the above facility for the purpose of conducting a case management inspection. LPA met with Jospeh Raya- (OM) who granted access to the facility and discussed the late reporting of an incident that occurred on 11/25/2023 and reported to the department on 12/07/2023. Written reports must be submitted within seven working days to the department. Compliance Officer Devorah Weiss(CO) met with LPA and CO discussed plan of correction. CO took responsibility for late reporting. CO also shared facility's incident report training PowerPoint, IR cheat sheet and list of employees that completed training. Per California Code Regulations Title 22, Division 6, Chapter 1, one deficiency will be cited. See LIC809-D for details. An exit interview was conducted, and a copy of this report was left with OM.

report_type: Facility Evaluation

visit_type: Case Management

met_with: Joesph Raya-Ward Operations Manager (OM)


summary: Facility Evaluation

raw_content:
Narrative:
On May 24, 2024 at 12:58pm, Licensing Program Analyst (LPA) Christine Wilson made an unannounced Case Management Incident Inspection to the above listed facility, regarding SIR dated 05/19/24. LPA was greeted by the Clinical DIrector (CD) who provided entry into the home.. During the course of the incident investigation, it was revealed that on 05/18/24, staff (S1) had not prepared, or reported dosage given of medication in MAR and did not sign off on Kipu, which resulted in staff not administering medication to (C1) according to the physician's directions, resulting in (C1) receiving a double dosage of medication. LPA Wilson interviewed (FN and CD).(LIC811 dated 05/24/24). A (1) deficiency has been determined at this time. The following deficiency has been cited. (See LIC 809D) An exit interview was conducted and Plans of Correction was developed and reviewed with the licensee. A copy of this report and appeals rights were discussed and left with licensee. (CD) whose signature on this form confirm receipt of these documents.

met_with: Clinical Director


summary: Facility Evaluation

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Narrative:
On November 18, 2024 at 12:22 pm, Licensing Program Analyst (LPA) Christine Wilson made an unannounced visit to the above listed facility, in order to conduct a case management incident inspection, regarding SIR dated 11/06/24.LPA was met by (CO) and (PD). During the course of the incident investigation, it was revealed that on 11/06/24; due to the Malibu fires, SoCal power pre-emptively turned off all power in this region. The decision was made to move all clients; six (6) from the Calabasas facility and six (6) from the Agoura facility to the Evolve Aura location in Tarzana, which had three (3) clients in care, which resulted in the licensee operating the facility beyond the conditions and limitations, as specified on the license. A (1) deficiency Type A has been determined at this time. The following deficiency has been cited. (See LIC 809D) An exit interview was conducted and Plans of Correction was developed and reviewed with the licensee. A copy of this report and appeals rights were discussed and left with licensee. (CO) whose signature on this form confirm receipt of these documents.

met_with: Compliance Officer


facility_name: FALCON GROVE CRISIS HOME

summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
It was alleged that a staff physically abused a facility client resulting in an injury, and a facility client sustained an injury due to neglect by facility staff. The investigation revealed that a facility client was in a bathtub thrashing around, kicking his legs, throwing his arms around and hitting the bathtub with his fist along with trying to kick and hit staff with his fists. The client alleged that a staff, Reference #1, pulled his arm to restrain him during the incident causing an arm injury. Reference #1 stated that the client sustained the injury from hitting the wall with his left fist and denied intentionally hurting the client when he assisted the client out of the bathtub during the episode. Another staff who assisted with the client during the episode denied witnessing Reference #1 physically abuse the client. Confidential documents obtained ruled the injury as accidental. Based on the information gathered, although the allegations may have happened or is valid, the preponderance of evidence to prove the allegations was not met, therefore the allegations are unsubstantiated. A copy of this report, Confidential Names Form and Appeal Rights were provided to the facility representative. There were no deficiencies cited during this inspection.

Investigation Findings:
13On June 25, 2021 at 12: PM, Licensing Program Analyst (LPA) Joshua Rarela conducted a follow-up inspection to deliver the findings of a complaint investigation concerning the allegations above. The complaint was investigated by Community Care Licensing Investigations Branch, State Investigator Elisia Rippe. LPA Rarela discussed the findings with the facility representative named above. During the course of the investigation, Investigator Rippe interviewed the placement agency social worker on 3/30/21 and 4/2/21, facility administrator on 5/11/21 and 5/12/21, a facility client on 5/12/21, a facility client's parent on 5/20/21, and facility staff on 5/24/21 (see Confidential Names Form dated June 25, 2021). Investigator Rippe also reviewed documents on 3/19/21, 3/27/21, 5/18/21 and 6/2/21 including the police report, hospital records, child welfare services reports, and the file review documents obtained on 3/19/21. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Gustavo Garcia LICENSING EVALUATOR NAME: Joshua Rarela LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: FALCON GROVE CRISIS HOMEFACILITY NUMBER: VISIT DATE: 06/25/2021

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

report_type: Complaint Investigation

met_with: Stacy Krebs, Administrator

complaint_status: unsubstantiated


raw_content:
Narrative:
The LPA reviewed the following documents: Falcon Grove Crisis Home Employee, Phone List, Register of Facility Clients, Personnel Report (LIC500), Kern County Department of Human Services (DHS) - Child Protective Services (CPS) Child Abuse Hotline (CAHL), Kern County DHS - CPS Screener Narrative, Kern County DHS - CPS Emergency Response Notice of Referral Disposition, San Joaquin County HSACSB - CAHL, San Joaquin County HSACSB Screener Narrative, San Joaquin Emergency Response Notice of Referral Disposition, Client Ref. # Behavioral Treatment Plan/Individual Program Plan, Special Incident Reports, Bakersfield Police Department Report. Ref. #2 denied the allegations stating that Ref. #1 targeted and threatened them, because Ref. #2 chose to work with the other client at the facility. The investigation revealed that the witness did not recall the incidents or the name of the perpetrator, although the witness continued to allege that they were hit and cursed at. The investigation revealed that CPS found the allegations to be Inconclusive. Bakersfield Police Department was unable to determine if an offense occurred due to conflicting statements and Ref. #2 having a history of making false accusations. A review of records indicates that Ref. #1 has a history of threatening staff, engaging in inappropriate attention seeking and actions of self-harm. There were no witnesses to the allegations and the LPA was unable to corroborate the allegations. So, although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred, therefore the allegations are unsubstantiated. There are no deficiencies to be cited regarding this allegations. A copy of this complaint was provided to the facility representative.

Investigation Findings:
On October 5, 2022 at 11:10 a.m., Licensing Program Analyst (LPA), Karen McGee, delivered the findings of the complaint investigation to the facility. The LPA met with Administrator, Amanda Allen On March 4, 2022, the Monterey Park Children's Residential Program (MPCRP), received a complaint with the above mentioned allegations. Confidential interviews were conducted that included, but were not limited to: the former Administrator, now the Trainer, Stacy Krebs and Valley Mountain Regional Center Service Coordinator (VMRCSC) 1, via telephone on September 20, 2022; VMRCSC 2 via telephone on September 26, 2022; one client, Ref. #1 via telephone on September 27, 2022; one Direct Care Staff (DCS), Ref. #2 via telehone on September 29, 2022; and one VMRC Senior Community Services Liaison email October 3, 2022. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jean Herring LICENSING EVALUATOR NAME: Karen McGee LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION LA & TRI-COASTAL CR, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: FALCON GROVE CRISIS HOMEFACILITY NUMBER: VISIT DATE: 10/06/2022

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

met_with: Amanda Allen


summary: Facility Evaluation

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Narrative:
On April 26, 2022, Licensing Program Analysts (LPA) Jean Herring arrived at the facility at 10: AM for the purpose conducting an unannounced Annual/Required inspection of the facility. LPA met with Amanda Allen, Administrator; Jose Cortez, Facility Manager; Stacy Krebs, Trainer. The group home is licensed to serve three (3) male/female developmentally disabled clients, ages 7 - 17. Facility has no children placed at this time. Physical Plant This facility is a one-story home with three(3) bedrooms, an office, two (2) full bathrooms, kitchen, dining, and living room. The license is posted in a prominent, publicly accessible location in the facility. Disinfectants and cleaning solutions are locked in a cabinet located next to the bathroom. Sharps and knives are locked in the office. Facility has non-perishable foods for at least one week and perishable foods for at least two days. Facility provides at least three(3) meals per day. Facility stores and locks medications in the office closet. Facility's first aid kit meets the requirements. All kitchen, food preparation, and storage areas are kept clean and free of rodents and other vermin. Carbon monoxide detectors and smoke alarms were tested and observed to be operable. Facility provides basic laundry services. Room temperatures are maintained at a comfortable temperature. The hot water temperature was tested and measured at 126 degrees F. Fire extinguisher is fully charged. All toilets, hand washing and bathing facilities are maintained in safe and sanitary operating condition and meet the requirements. Each client has his/her own bedroom. All beds are in good repair and supplied with pillows and linens which are clean and in good repair. Operational Requirements Facility maintains a register of clients and the register is available upon request. Facility maintains a fire clearance. Facility maintains and implements written complaint procedures and the procedures are posted in a publicly accessible location in the facility. (cont...) Disaster Preparedness Plan Facility has a current LIC 610C Emergency Disaster Plan. Facility conducts disaster drill at least once a month The drills are documented and the documentation is maintained in the facility for at least a year. Facility maintains an emergency and disaster plan and register of clients with contact information for each client's responsible party and physician. Emergency Intervention Plan Facility maintains a monthly log of each use of manual restraints that contains all required information. The log is available for review by the Department upon request. LPA observed documentation of Emergency Intervention Training and on-going training. Client Records LPA reviewed one (1) client record (C1- last client discharged from the facility). Client records are available to the licensing agency to inspect, audit and copy upon demand. Client records contain required information including, but not limited to: Identification and Emergency Information; Admission Agreement; consent forms; needs and services plan and/or Individual Program Plan; medical assessment; TB test; dental, vision, medical, and psychological reports; personal property and valuables; personal rights forms; and medication administration records. During this inspection, the following deficiencies were observed: - Facility does not have an updated emergency and disaster plan that includes procedures required by HSC 1565(a)(7); HSC 1565(e) and HSC 1565(f). - Hot water temperature reading was at 126 degrees F. These pose a potential Health, Safety, or Personal Rights risk to clients in care. Deficiency citations were issued. A signed copy of this report was provided to the facility along with LIC 809Ds, LIC 811 (Confidential Name/s list) and Appeal Rights. These pose a potential Health, Safety, or Personal Rights risk to clients in care. Deficiency citations were issued. A signed copy of this report was provided to the facility along with LIC 809Ds, LIC 811, and Appeal Rights.

visit_type: Annual


summary: Facility Evaluation

raw_content:
Narrative:
On April 27, 2023, at 1: PM Licensing Program Analyst (LPA) Ashley Ruacho conducted an unannounced inspection at the above facility for the purpose of conducting an annual/required inspection. LPA met with facility Administrator, Amanda Allen. LPA and Administrator toured the facility. The group home is licensed to serve three (3) male/female developmentally disabled clients, ages 7 - 17. Physical Plant This facility is a one-story home with three (3) bedrooms, an office, two (2) full bathrooms, kitchen, dining, and living room. The license is posted in a prominent, publicly accessible location in the facility. Disinfectants and cleaning solutions are locked in a cabinet located next to the bathroom. Sharps and knives are locked in the office. Facility has non-perishable foods for at least one week and perishable foods for at least three days. Facility provides at least three (3) meals per day. Facility stores and locks medications in the office closet. Facility's first aid kit meets the requirements. All kitchen, food preparation, and storage areas are kept clean and free of rodents and other vermin. Carbon monoxide detectors and smoke alarms were tested and observed to be operable. Facility provides basic laundry services. Room temperatures are maintained at a comfortable temperature. The hot water temperature was tested and measured at 112.5 degrees F. Fire extinguisher is fully charged and last serviced on January 17th, 2023. All toilets, hand washing and bathing facilities are maintained in safe and sanitary operating condition and meet the requirements. Each client has his/her own bedroom. All beds are in good repair and supplied with pillows and linens which are clean and in good repair. Operational Requirements Facility maintains a register of clients and the register is available upon request. Facility maintains a fire clearance. Facility maintains and implements written complaint procedures, and the procedures are posted in a publicly accessible location in the facility. Disaster Preparedness Plan Facility has a current LIC 610C Emergency Disaster Plan. Facility conducts disaster drill at least once a month The drills are documented, and the documentation is maintained in the facility for at least a year. Facility maintains an emergency and disaster plan and register of clients with contact information for each client's responsible party and physician. Emergency Intervention Plan Facility maintains a monthly log of each use of manual restraints that contains all required information. The log is available for review by the Department upon request. LPA observed documentation of Emergency Intervention Training and on-going training. Client Records LPA reviewed two (2) client records. Client records are available to the licensing agency to inspect, audit and copy upon demand. Client records contain required information including, but not limited to: Identification and Emergency Information; Admission Agreement; consent forms; needs and services plan and/or Individual Program Plan; medical assessment; TB test; dental, vision, medical, and psychological reports; personal property and valuables; personal rights forms; and medication administration records. For this review, two (2) Kern Regional Center clients were selected for the sample to assess the level of care and services they receive. Additionally, LPA reviewed three (3) staff files for compliance with Title Regulations and Interim Licensing Requirements. LPA conducted interviews with two staff members. LPA interviewed one client and the other client was unable to be interviewed due to a speech delay. An exit interview was conducted. LPA provided the facility administrator a signed copy the LIC 809 and LIC 811 reports. There were no deficiencies cited at the time of this inspection.


summary: Facility Evaluation

raw_content:
Narrative:
On May 9th, 2023, at 2:50pm Licensing Program Analyst (LPA) Ashley Ruacho conducted an unannounced visit at the above facility. The purpose of the visit was to finalize the inspection tool that was not completed during the annual inspection conducted on April 27th, 2023. LPA met with the administrator Amanda Allen and completed the inspection tool. An exit interview was conducted. LPA provided the facility administrator a signed copy the LIC 809. There were no deficiencies cited at the time of this inspection.


summary: Facility Evaluation

raw_content:
Narrative:
On April 30th, 2024, at 12: PM Licensing Program Analyst (LPA) Ashley Ruacho conducted an unannounced inspection at the above facility for the purpose of conducting an annual/required inspection. LPA met with facility Administrator, Amanda Allen. LPA and Administrator toured the facility. Physical Plant This facility is a one-story home with three (3) bedrooms, an office, two (2) full bathrooms, kitchen, dining, and living room. The license is posted in a prominent, publicly accessible location in the facility. Disinfectants and cleaning solutions are locked in a cabinet located next to the bathroom. Sharps and knives are locked in the office. Facility has non-perishable foods for at least one week and perishable foods for at least three days. Facility provides at least three (3) meals per day. Facility stores and locks medications in the office closet. Facility's first aid kit meets the requirements. All kitchen, food preparation, and storage areas are kept clean and free of rodents and other vermin. Carbon monoxide detectors and smoke alarms were tested and observed to be operable. Facility provides basic laundry services. Room temperatures are maintained at a comfortable temperature. The hot water temperature was tested and in working order. Fire extinguisher is fully charged and last serviced on January 15th, 2024. All toilets, hand washing and bathing facilities are maintained in safe and sanitary operating condition and meet the requirements. Each client has their own bedroom. All beds are in good repair and supplied with pillows and linens which are clean and in good repair. Operational Requirements Facility maintains a register of clients and the register is available upon request. Facility maintains a fire clearance. Facility maintains and implements written complaint procedures, and the procedures are posted in a publicly accessible location in the facility. Disaster Preparedness Plan Facility has a current LIC 610C Emergency Disaster Plan. Facility conducts disaster drill at least once a month The drills are documented, and the documentation is maintained in the facility for at least a year. Facility maintains an emergency and disaster plan and register of clients with contact information for each client's responsible party and physician. Emergency Intervention Plan Facility maintains a monthly log of each use of manual restraints that contains all required information. The log is available for review by the Department upon request. LPA observed documentation of Emergency Intervention Training and on-going training. Client Records LPA reviewed two (2) client records. Client records are available to the licensing agency to inspect, audit and copy upon demand. Client records contain required information including, but not limited to: Identification and Emergency Information; Admission Agreement; consent forms; needs and services plan and/or Individual Program Plan; medical assessment; TB test; dental, vision, medical, and psychological reports; personal property and valuables; personal rights forms; and medication administration records. For this review, two (2) Kern Regional Center clients were selected for the sample to assess the level of care and services they receive. Additionally, LPA reviewed three (3) staff files for compliance with Title Regulations and Interim Licensing Requirements. LPA conducted interviewed three (3) staff members. LPA did not interview any client's due clients being at school. There were no deficiencies cited at the time of this inspection. An exit interview was conducted. LPA provided the facility administrator a signed copy the LIC 809 and LIC 811 reports.

met_with: Amanda Allen - Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On May 1st, 2025, at 11: AM Licensing Program Analyst (LPA) Ashley Ruacho conducted an unannounced inspection at the above facility for the purpose of conducting an annual/required inspection. LPA met with facility Administrator, Amanda Allen. LPA and Administrator toured the facility. Physical Plant This facility is a one-story home with three (3) bedrooms, an office, two (2) full bathrooms, kitchen, dining, and living room. The license is posted in a prominent, publicly accessible location in the facility. Disinfectants and cleaning solutions are locked in a cabinet located next to the bathroom. Sharps and knives are locked in the office. Facility has non-perishable foods for at least one week and perishable foods for at least three days. Facility provides at least three (3) meals per day. Facility stores and locks medications in the office closet. Facility's first aid kit meets the requirements. All kitchen, food preparation, and storage areas are kept clean and free of rodents and other vermin. Carbon monoxide detectors and smoke alarms were tested and observed to be operable. Facility provides basic laundry services. Room temperatures are maintained at a comfortable temperature. The hot water temperature was tested and in working order. Fire extinguisher is fully charged and last serviced on January 7th, 2025. All toilets, hand washing and bathing facilities are maintained in safe and sanitary operating condition and meet the requirements. Each client has their own bedroom. All beds are in good repair and supplied with pillows and linens which are clean and in good repair. Operational Requirements Facility maintains a register of clients and the register is available upon request. Facility maintains a fire clearance. Facility maintains and implements written complaint procedures, and the procedures are posted in a publicly accessible location in the facility. Disaster Preparedness Plan Facility has a current LIC 610C Emergency Disaster Plan. Facility conducts a disaster drill at least once a month. The drills are documented, and the documentation is maintained in the facility for at least a year. Facility maintains an emergency and disaster plan and register of clients with contact information for each client's responsible party and physician. Emergency Intervention Plan Facility maintains a monthly log of each use of manual restraints that contains all required information. The log is available for review by the Department upon request. LPA observed documentation of Emergency Intervention Training and on-going training. Client Records For this inspection, LPA Ruacho reviewed two (2) Kern Regional Center clients. They were selected for the sample to assess the level of care and services they receive. Client records are available to the licensing agency to inspect, audit and copy upon demand. Client records contain required information including, but not limited to: Identification and Emergency Information; Admission Agreement; consent forms; needs and services plan and/or Individual Program Plan; medical assessment; TB test; dental, vision, medical, and psychological reports; personal property and valuables; personal rights forms; and medication administration records. Staff Records LPA reviewed three (3) staff files for compliance with Title Regulations and Interim Licensing Requirements. LPA conducted interviewed one (1) staff members. LPA did not interview any client's due clients being at school. There were no deficiencies cited at the time of this inspection. An exit interview was conducted. LPA provided the facility administrator a signed copy the LIC 809 and LIC 811 reports.

met_with: Amanda Allen- Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On April 2nd, 2026, at 11: AM Licensing Program Analyst (LPA) Ashley Ruacho conducted an unannounced inspection at the above facility for the purpose of conducting an annual/required inspection. LPA met with facility Administrator, Amanda Allen. LPA and Administrator toured the facility. Physical Plant This facility is a one-story home with three (3) bedrooms, an office, two (2) full bathrooms, kitchen, dining, and living room. The license is posted in a prominent, publicly accessible location in the facility. Disinfectants and cleaning solutions are locked in a cabinet located next to the bathroom. Sharps and knives are locked in the office. Facility has non-perishable foods for at least one week and perishable foods for at least three days. Facility provides at least three (3) meals per day. Facility stores and locks medications in the office closet. Facility's first aid kit meets the requirements. All kitchen, food preparation, and storage areas are kept clean and free of rodents and other vermin. Carbon monoxide detectors and smoke alarms were tested and observed to be operable. Facility provides basic laundry services. Room temperatures are maintained at a comfortable temperature. The hot water temperature was tested and in working order. Fire extinguisher is fully charged and last serviced on January 8th, 2026. All toilets, hand washing and bathing facilities are maintained in safe and sanitary operating conditions and meet the requirements. Each client has their own bedroom. All beds are in good repair and supplied with pillows and linens which are clean and in good repair. Operational Requirements Facility maintains a register of clients and the register is available upon request. Facility maintains a fire clearance. Facility maintains and implements written complaint procedures, and the procedures are posted in a publicly accessible location in the facility. Disaster Preparedness Plan Facility has a current LIC 610C Emergency Disaster Plan. Facility conducts disaster drills at least once a month. The drills are documented, and the documentation is maintained in the facility for at least a year. Facility maintains a register of clients with contact information for each client's and physician responsible. Emergency Intervention Plan Facility maintains a monthly log of each use of manual restraints that contains all required information. The log is available for review by the Department upon request. LPA observed documentation of Emergency Intervention Training and on-going training. Client Records For this inspection, LPA Ruacho reviewed two (2) Kern Regional Center clients. They were selected for the sample to assess the level of care and services they receive. Client records are available to the licensing agency to inspect, audit and copy upon demand. Client records contain required information including but not limited to: Identification and Emergency Information; Admission Agreement; consent forms; needs and services plan and/or Individual Program Plan; medical assessment; TB test; dental, vision, medical, and psychological reports; personal property and valuables; personal rights forms; and medication administration records. Staff Records LPA reviewed three (3) staff files for compliance with Title Regulations and Interim Licensing Requirements. LPA conducted interviewed one (1) staff members. LPA did not interview any client's due to one (1) client being nonverbal and other client declined. Per CCR 84065(b)(1)(A) and 84065(i)(3)(V), staff training requirements were not met at the time of this inspection. A citation was issued during today's inspection. A plan of correction was discussed and developed with the above representative. An exit interview was conducted and a copy of this report along with the appeal rights were given to the Administrator.


facility_name: FONTANELLA CARE HOME

summary: Facility Evaluation

raw_content:
Narrative:
On September 23, 2025 at 10: AM, LPA Michelle Silvas and LPM Tamara Hill conducted an in person office meeting with Susan Peralta Partisala and Karren Melegrito. The purpose of the meeting was to continue the group home application process by conducting the Component II orientation. LPM Tamara Hill explained the purpose of the meeting and LPA Silvas obtained copies of the participants driver's licenses. The following issues were discussed and/or addressed: The LIC200 indicates that you are willing to accept children ages 0-6 which have specific requirements and elevated staff qualifications. If you are still planning this, please read the regulations for Under Six and address the staffing levels, qualifications, and other requirements as necessary. Licensing Forms - need to filled out appropriately. There are several identified issues with the forms. Staff Training - the majority of the staff training speaks to adult clientele but your application is for under age 18. Please address this section appropriately. Facility Program Description - Your entire program description is build on the premise that you would be serving adult clientele but your application is for youth. In addition, your LIC200 and the LIC9106 both indicate that you plan to serve youth under the age of six but none of the requirements for this population is included in your both Program Description and Program Statement portions of your application. Continue LIC 809-C LLC documentation and members. According to the documentation you provided that were approved by Secretary of State, it indicates that you are required to have a Board of Managers (page 2 of the "Limited Liability Company Agreement of SP Care One LLC dba Fontanella Care Home". Discipline Policies - must be geared to children, use positive discipline, and be trauma informed and culturally relevant. Personal Rights - must be about educating children/youth in an age-appropriate and trauma informed manner their rights as it pertains to being in out of home care. Training curriculum needs to be about training of staff to serve children/youth in care. Admissions Agreement Transportation Program Statement Scheduled pre-licensing for further date once fire clearance is approved and program statement is submitted. Component III will be scheduled and provider will be notified of the date and time. Component III will be conducted electronically.

met_with: Susan Peralta Partisala Licensee & Karren Melegrito Administrator


facility_name: FRED FINCH YOUTH CENTER - NEW YOSEMITE

summary: Complaint Investigation - Unsubstantiated

raw_content:
Narrative:
Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the facility conducted an illegal eviction, therefore the above allegation is unsubstantiated. Exit interview conducted with SD and LPA left report at the facility.

Investigation Findings:
13Licensing Program Analyst (LPA) Christopher Rollins conducted a follow-up complaint inspection at Fred Finch and met with Mar Smith Senior Director (SD). The purpose of the inspection was to deliver the finding for the above complaint allegation. During the course of investigating these allegations, LPA Rollins conducted confidential interviews with facility staff, clients, social workers and conducted clients file review. Confidential interviews reveal conflicting stories about facility conducting an illegal eviction. Based on interviews and documentation there was not enough evidence to prove that facility conducted an illegal eviction. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Zaid Hakim LICENSING EVALUATOR NAME: Christopher Rollins 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 14-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, TRAEGER AVE., SUITE FACILITY NAME: FRED FINCH YOUTH CENTER - NEW YOSEMITEFACILITY NUMBER: VISIT DATE: 01/05/2022

met_with: Mar Smith-Senior Director


summary: Complaint Investigation - Substantiated

raw_content:
Investigation Findings:
13Licensing Program Analyst (LPA) Shikya Belfield and Lisette Valenzuela conducted a follow-up complaint inspection at Fred Finch and met with Rising Oaks administrator Kelli Knox and Avolon administrator Grace Helton. The purpose of the inspection was to deliver the findings for the above complaint allegation. During the course of investigating this allegations, LPA Belfield conducted confidential interviews and reviewed documentation to include but not limit email communications and incident reports. It was determined that the program did not give proper notice when evicting the client from the program and failed to pick them up from the hospital. The propinderance of evidence has been met, therefore this allegation is Substantiated. Facility cited for violation of California Code of Regulations, Title 22, Division Six, Section 84068. Removal and/or Discharge Procedures. An exit interview was conducted and a copy of this report along with apeal rights will be sent to Adminsitrator Kellie Knox. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Carolyn Flynn LICENSING EVALUATOR NAME: Shikya Belfield 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 14-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: FRED FINCH YOUTH CENTER - NEW YOSEMITEFACILITY NUMBER: 015650088

met_with: Kellie Knox

complaint_status: SUBSTANTIATED


raw_content:
Investigation Findings:
13On 1/20/23, Licensing Program Analyst (LPA) Mariah Hawkins made a visit to the facility to deliver findings of an investigation of the above allegations. LPA met with Senior Director Mar Smith and informed of the purpose of the visit. Based on confidential interviews with resident, staff, and witnesses, the resident was provided food, clothes were clean, and hygiene needs were met. Based on LPA's observation of resident, resident was clean and tidy with clean and well-fitting clothes and appeared in good spirits. Additionally, resident expressed liking the facility and staff and feeling safe there. Further, authorized representatives expressed having no concerns with the care they have observed the resident to be receiving at the facility. However, after multiple attempts, LPA was unable to obtain a statement from all reported witnesses of the specific concerns regarding the care of the resident. Although the allegations may have happened or are valid, based on LPA's observations and interviews, there is not a preponderance of the evidence to prove the alleged violations did or did not occur. Therefore, the allegation is unsubstantiated. An exit interview was conducted, appeal rights discussed, and a copy of this report provided to Senior Director Mar Smith, whose signature on this form confirms receipt. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Isabel Mendoza LICENSING EVALUATOR NAME: Mariah Hawkins 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 1

met_with: Senior Director Mar Smith


raw_content:
Narrative:
continued from LIC Other documents viewed stated the interviewee said the incident never occurred. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that staff pushed minor. Therefore, the above allegation is UNSUBSTANTIATED. Regarding the allegation staff did not properly report the incident involving minor in home: During the course of the investigation, Licensing Program Analyst (LPA) conducted confidential interviews with staff, clients, and conducted document research. During confidential interviews, inconsistent information was provided. Some interviewees stated that the incident was immediately reported within regulation while others did not find out about the incident until a later time. LPA conducted document research and found inconsistent information. Proper notification by the facility was sent to CDSS within regulation, while client representatives state they learned of the incident hours later. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that staff did not properly report the incident involving minor in home. Therefore, the above allegation is UNSUBSTANTIATED. Regarding the allegation minor was not permitted scheduled visit: During the course of the investigation, Licensing Program Analyst (LPA) conducted confidential interviews with staff, clients, and conducted document research. During confidential interviews, inconsistent information was provided. Most interviewees stated that the meeting was missed by accident and rescheduled two days later. A representative stated that the meeting was purposely missed and not rescheduled. LPA conducted document research and found no evidence to support that minor was not permitted scheduled visit. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that minor was not permitted scheduled visit. Therefore, the above allegation is UNSUBSTANTIATED. continued on LIC 9099 continued from LIC 9099-C Regarding the allegation that minor's dietary needs are not being met: During the course of the investigation, Licensing Program Analyst (LPA) conducted confidential interviews with staff, clients, and conducted document research. During confidential interviews, inconsistent information was provided. Most interviewees stated that the client is placed on a specific diet and provided planned meals for their condition. Sometimes the client refuses the meals provided. Small measured portions of other foods are provided, the client cannot be denied the right to eat. Other interviewees stated that there is no specific dietary meals provided to meet the client's needs. LPA conducted document research and found no evidence to support that minor's dietary needs are not met. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that minor's dietary needs not being met. Therefore, the above allegation is UNSUBSTANTIATED. An exit interview was conducted and a copy of this report was given to Mar Smith Senior Director.

Investigation Findings:
13On 9-27-23 10:43AM, Licensing Program Analyst (LPA's)George Karkazis and Celeste Aparicio, conducted an unannounced inspection at Fred Finch New Yosemite and met with Mar Smith, Senior Director, who helped with the inspection. The purpose of the inspection was to deliver the complaint findings. Regarding the allegation staff pushed minor: During the course of the investigation, Licensing Program Analyst (LPA) conducted confidential interviews with staff, clients, and conducted document research. During confidential interviews, inconsistent information was provided. Some interviewees stated that a staff pushed a minor but did not witness it, other interviewees stated it never happened. LPA conducted document research and found a client reported that staff pushed them in an incident report. continued on LIC 9099-C UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Isabel Diego LICENSING EVALUATOR NAME: George Karkazis 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 14-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SAN BRUNO ASC, TRAEGER AVE., SUITE FACILITY NAME: FRED FINCH YOUTH CENTER - NEW YOSEMITEFACILITY NUMBER: VISIT DATE: 09/27/2023

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

met_with: Mar Smith, Senior Director


raw_content:
Investigation Findings:
13On 2-20-25 9:30AM, Licensing Program Analyst (LPA) George Karkazis conducted an unannounced inspection at Fred Finch New Yosemite and met with Mar Smith, Senior Director, who helped with the inspection. The purpose of the inspection was to deliver the complaint findings. The complaint alleged that staff is engaging in inappropriate sexual behavior with minors. LPA Karkazis conducted confidential interviews and document research, in which inconsistent information was provided. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the allegation occurred. Therefore, the allegation is UNSUBSTANTIATED. A copy of this report was given to Mar Smith, Senior Director. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Isabel Diego LICENSING EVALUATOR NAME: George Karkazis 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 1

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


raw_content:
Investigation Findings:
13On 3-14-25 1:00PM, Licensing Program Analyst (LPA) George Karkazis conducted an unannounced inspection at Fred Finch New Yosemite, and met with Brandy Hunt, Administrator, who helped with the inspection. The purpose of the inspection was to deliver the complaint findings. The complaint alleged that the minor was sexually abused. LPA Karkazis and CDSS Investigations Branch conducted confidential interviews and document research, in which inconsistent information was provided. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the allegation occurred. Therefore, the allegation is UNSUBSTANTIATED. A copy of this report was given to Brandy Hunt, Administrator . UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Isabel Diego LICENSING EVALUATOR NAME: George Karkazis 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 1

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

met_with: Brandy Hunt, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Christopher Rollins conducted an unannounced annual inspection at Fred Finch Youth Center-New Yosemite. During the inspection, LPA met with Mar Smith Senior Director (SD). The group home is licensed to served 4 clients ages 8-17. The facility consists of 4 bedrooms (4 single occupancy) and 4 bathrooms (3 client and 1 staff). The facility also has a activity and staff room. At 10: AM, LPA Rollins toured the facility with SD inside and out. LPA observed the kitchen is clean. Hot water in kitchen, bathroom and shower measured at 113.4 degrees F which is currently between 105-120 required degrees F. The facility has plenty of non perishable and non- perishable food supply. All items in the refrigerator are correctly labeled and no spoiled food was found. Medication, cleaning supplies and knives are locked away in a secure location. There are enough folks, spoons, plates and cups. All passageways are unobstructed. All smoke detectors are up to date and working. The facility is clean, safe and sanitary. There are no firearms on the property. There are no bodies of water on the property. The facility is maintained at a comfortable temperature. Personal rights, floor plan, food menu and Emergency disaster forms were posted in clear view. Fire Extinguisher was up to date and carbon monoxide was in good working shape. LPA observed all activity logs and emergency policies to be up to date. At 12: PM, LPA reviewed three client files with SD. LPA observed all three client files and found no deficiencies. Needs and services plan are updated. The documentation is in the clients files are complete. LPA observed medication logs to be updated and current. At 1: PM, LPA observed eleven staff files with SD and found no deficiencies. Staff have completed there 20 hours annual training. All staff documentation is current. LPA reviewed staff training documents with SD and found all training to be up to date and all certificates to be complete. During inspection, LPA receive an updated copy of the LIC Personnel Report and updated Emergency Disaster Plan (LIC C) to maintain their file current. A review of Licensing Information System on July 29, 2021 indicates that all facility staff associated to the facility had DOJ, FBI and child abuse index check clearances. Per Title Regulations, no deficiencies were cited during the inspection. Exit interview was conducted and a copy of the report was left at the facility.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analysts (LPA) George Karkazis and Alyssa Ng conducted an unannounced Annual/Random inspection at Fred Finch Youth Center. LPA's met with Mar Smith, Senior Director (SD) and toured the facility, inside and out. The group home is licensed to serve four clients. Currently in placement are three clients. Present during this inspection were three clients and two staff. At 10:50, LPAs walked over to the New Yosemite house. When walking in, LPA saw four bedrooms, single occupancy, and three bathrooms. Two of the bathrooms were for clients and one is for staff. LPA's observed the facility license, client's personal rights, facility sketch, facility rules, and other forms posted on the walls throughout the facility. LPA interviewed two of the clients in care and two staff. LPA reviewed client and staff files which was updated and in order. All staff were fingerprinted and had child abuse index check clearances. LPA tested the water temperature and found it to read 114.4 degrees, which is within range. At 11: AM, LPAs toured the backyard. There were no open bodies of water or debris. LPAs noticed a wooden fence surrounding the backyard. One plank was missing. There was a swing and a seesaw with rubber shavings on the bottom. LPA noticed two window screens that were broken from the clients back window. LPA advised SD to get the screens and fence repaired immediately. SD stated that there was a work order for the fence and that she will have maintenance replace the screen immediately. ------Cont. ON 809C----------- When coming back into the facility, LPA noticed the vent was coated with dust. LPA advised SD to have the vent cleaned. SD said that she will have maintenance clean it right away. At 12:15, LPA walked into the kitchen and noticed that the facility menu was not posted anywhere. When asked about the facility menu, SD mentioned that it was in the main kitchen which is adjacent to the house. SD printed an updated menu and put it on the refrigerator in clear view. There was sufficient 2 day perishables and 7 day non-perishable. Sharps and chemicals were located in staff closet. The medication was also locked away and stored in the staff room. During staff and client interviews, it was disclosed that the fence has been broken for at least three weeks. Facility cited for violation of California Code of Regulations, Title Division Six, regulation 80087 (b) Buildings and Grounds. See attached 809-D. At this time, 1 deficiency and 3 technical violations were cited during this inspection. An exit interview was conducted, appeal rights discussed and a copy of the report was left at the facility with Mar Smith, Senior Director.

met_with: Mar Smith


facility_name: FREEDOM HOUSE

summary: Facility Evaluation

raw_content:
Narrative:
On October 26, 2021 at 10:00am Licensing Program Analyst (LPA) Donald Martin arrived at the Freedom House for the purpose of conducting an Annual/Required inspection. LPA was met by Lydia Quintanilla and allowed to enter the facility. The inspection is as follows: Front door entry leads into the living room where the clients personal rights, facility profile and grievance policy and forms are posted for clients to see. There are two rooms off the living room. One contains several computers for the clients use and the other is a game room with a pool table and a small weight room for clients use. The kitchen has a large stove with a hood that has a sprinkler system. Clients use the stove for independent skill building but for the most part staff cooks for the clients. The refrigerator was clean and has a two day supply of food. The pantry has plenty of food and can goods. There is a weeks worth of non perishable foods as well. The facility receives food through InstaCart and Homies Unidos. There is a room with a Subzero freezer and an additional refrigerator for food storage. There is a locked closet that contains tool and cleaning supplies that is inaccessible to clients. There is another room that has lockers for the clients to store personal items. There is a bedroom downstairs used for overnight staff use only. There are two bathrooms downstairs as well. Upstairs. There are 8 bedrooms upstairs only 1 is in use at the time of the visit. The rooms are very big and spacious. The client had plenty of clothing and storage room for him to store them away. There is a room used for storage that stays locked that contains hygiene products and stationary, backpacks and other donated school supplies for the clients. Linen is kept in the staff room downstairs. There is a fire alarm pull station and an unlocked exit door on either end of the hall. There are 3 bathrooms upstairs and 3 showers for the clients. Cont on 809-C There is an attic door that leads to a room that is empty. This door remains locked and inaccessible to clients. There is also a fire extinguisher in the hallway. The basement was very spacious and clean. The wall are decorated with art from people in the community and from some of the clients. The washer and dryer is located in the basement and can be used by the clients when supervised by staff. Knives are kept in a locked drawer in the office. The water temperature is 120 and within the state guidelines. There is a structure on the side of the house that is used for storage and inaccessible to clients. The outside has a large garden area surrounding the home. The structure is in fair shape as well as the garden. Note: There are 6 working camera angles noted by LPA on the premises. One in the hallway upstairs, one facing the door on the inside at the entrance, and four attached to the outside of the building that show the property only. Smoke detectors were noticed hard wired into the home but out of LPA's reach. The overall home inside and out was very clean and in order. Note: LPA discussed the cameras that are located at the facility. It was discussed that the cameras located inside of the facility need to be removed due to no camera waivers being permitted by CCL at this time. LPA also requested Lydia Quintanilla submit a letter regarding the outside cameras to my attention as soon as possible. There is one staff currently on duty at the facility; "S1". She is fingerprint cleared and associated to the facility. LPA will return to do staff and client file review and interviews. There are no deficiencies to report at the time of this visit. A copy of this report will be left with Administrator, Lydia Quintanilla.

met_with: Lydia Quintanilla-Interim Administrator


facility_name: FTBP - OPPORTUNITIES HOME FOR CHILDREN

summary: Complaint Investigation - Substantiated - 1 allegation

raw_content:
Narrative:
Furthermore, it was established that staff member S3 witnessed S2 yell at C1 but did not report the incident immediately, which also posed a risk to the other minors in care. Upon discovering the incident at a later date, the facility filed an incident report to notify the required parties and conducted its own internal investigation. Despite the presence of other staff members, established policies and procedures were not followed. Lpa J. Armstrong reviewed evidence, including the Special Incident Report, Police Report, and the Internal Investigation, which confirmed the allegations mentioned above. Based on LPA interviews and record reviews and evidence obtained, the preponderance of evidence standard has been met, therefore the allegation is found to be SUBSTANTIATED. Therefore, issued a citation in accordance with the California Code of Regulations, Title Division Six, regulation 80072(a)(3) Personal Rights. The exit interview was conducted with Audrey Hughes and a copy of this report was provided to the facility. (Continued on LIC 9099D)

Investigation Findings:
SubstantiatedEstimated Days of Completion: Estimated Days of Completion: Estimated Days of Completion:

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

met_with: AUDREY HUGHES


summary: Facility Evaluation

raw_content:
Narrative:
On 07/16/24 at 09: AM Licensing Program Analyst (LPA) Jhane Haynes and Licensing Program Manager Kevin Sauk made an announced visit to the above facility for the purpose of conducting a pre-licensing inspection. LPA met with Facility Administrator(FA) Audrey Hughes who granted access to the facility. Together FA, LPA and LPM toured the home inside and out. This is a single-story home located in a residential area. There are no swimming pools or bodies of water of the premises. LPA and LPM observed the following during facility tour: Entry contains posting not limited to personal rights, emergency numbers. Bedroom #1 is for ambulatory clients and contains a twin bed, drawers, desk, ceiling fan and adequate closet space. Secured Closet contains chemicals and cleaning supplies. Bathroom#1 contains functioning toilet, double sinks and shower with running water. Kitchen contains a kitchen island with seating and pantry with non-perishables with up to two weeks. The refrigerator operating temperature at 38 degrees and freezer at 0 degrees. There is operational kitchen appliances, adequate dinnerware for clients to be placed. A fire extinguisher and phone line can be found. Licensee will post weekly menu. Dining Area contained table and six chairs. Living Room contains adequate seating, rug with non-slip adhesive, TV, additional seating and desk for computer and activities. Bedroom #2 contains a twin bed, drawers, desk, ceiling fan and adequate closet space. Bathroom#2 is non-ambulatory and contains functioning toilet, sink and walk-in shower with running water. Laundry Room contains washer/dryer, cabinet space and secured exterior door to the garage. Garage contains extra laundry storage, water heater, water filter and exterior door to side of home. (Continue to LIC809-C) Bedroom #3 is for non-ambulatory clients and contains twin bed, desk, drawers and adequate closet space. There is a an exterior door that can be opened from the inside but locked on the outside. Bedroom #4 is for non-ambulatory clients and contains twin bed, desk, drawers and adequate closet space with built-in dresser. There is a an exterior door that can be opened from the inside but locked on the outside. Emergency Closet holds first aid kit with required dressings, emergency disaster kits. Activity Room contains seating, TV, game machine, two swings and shelving for activities. There is a secured storage closet for hygiene. Bathroom#3 contains functioning double sinks, separate tub and shower with running water. Toilet is closed off. Office contains seating, desk, locked boxes for clients, secured dresser for clients files. Medications are stored and will be administered here. Exterior contains outdoor seating, umbrellas, AC unit and fruit trees. Trash is stored on the outside the house. The exterior is clear and free of debris. The fire and carbon monoxide alarms were tested and operational. Fire extinguisher can be located in the kitchen and hallway before the activity room and sprinklers located throughout home. An exit interview was conducted, and a copy of this report was emailed to the administrator.

visit_type: Prelicensing

met_with: Audrey Hughes Facility Administrator(FA)


summary: Facility Evaluation

raw_content:
Narrative:
On 07/16/24 at 11:00, Component II of the application process for the above facility located at Raywood Dr Lancaster, CA 93536 was held after pre-licensing inspection. Attending Component II were the following individuals: Licensing Program Analyst (LPA) Jhane Haynes, Licensing Program Manager (LPM) Kevin Sauk and Facility Administrator (FA) Audrey Hughes. The purposes of this Component II meeting were to review the incomplete application and Program Statement and to resolve any concerns that may have existed. The following incomplete application forms were discussed during the meeting: LIC LIC Board of Director Statements LIC Staff Roster Floor Plan The Program Statement was reviewed and discussed. Revisions are to be made in the program design, not limited to: population served, training plan and house guidelines.


summary: Facility Evaluation

raw_content:
Narrative:
On 03/12/2025 at 09: AM, Licensing Program Analyst (LPA) Dennis Jarmin conducted an unannounced post-licensing inspection at FTBP Opportunities Home for Children. LPA met with Facility Administrator (FA) Audrey Hughes, who granted access and provided LIC 500 and LIC 9020. LPA inspected the entire facility. The Group Home is licensed to provide care and supervision for two ambulatory and two non-ambulatory children, ages 3-17 years. No swimming pools or bodies of water were observed on the premises. The facility maintains appropriate staff-to-child ratios and ensures that personnel meet training and background clearance requirements as mandated by group home regulations. Facility Overview: This single-story home is located in a residential area and includes four bedrooms, three full bathrooms, a living room, a dining room, a kitchen, a laundry area, a backyard, and a detached garage. The facility meets all physical plant safety requirements, ensuring a safe, clean, and comfortable environment for children in care. Entry: The required postings, including personal rights, emergency contact numbers, and emergency procedures, are displayed in a visible location. Bedrooms: Bedroom #1, designated for ambulatory clients, contains a twin bed, drawers, desk, ceiling fan, and closet space. Bedroom #2 is similarly furnished with a twin bed, drawers, desk, ceiling fan, and closet space. Bedroom #3, designated for non-ambulatory clients, includes a twin bed, desk, drawers, closet space, and an exterior door that can be opened from the inside but remains locked from the outside. Bedroom #4, also for non-ambulatory clients, has a twin bed, desk, drawers, a built-in dresser, closet space, and an exterior door with the same security feature. All sleeping areas comply with spacing, bedding, and emergency egress requirements. Bathrooms: Bathroom #1 is equipped with a toilet, double sinks, and a shower with running water. Bathroom #2, designated for non-ambulatory clients, contains a toilet, sink, and a walk-in shower. Bathroom #3 has double sinks, a separate tub, a shower with running water, and an enclosed toilet. Hot water temperature was tested and measured within the required range. Kitchen: The kitchen features an island with seating, a pantry stocked with non-perishable food for up to two weeks, and operational appliances including a refrigerator set at 38°F and a freezer at 0°F. Adequate dinnerware is available for clients. A fire extinguisher and a phone line are present. The licensee will post a weekly menu. Food storage and preparation areas were clean and met sanitary standards. Perishable food supplies were adequate for at least two days, and non-perishable supplies were sufficient for at least seven days. Dining Area: A table with six chairs is arranged in the dining area, providing sufficient space for all residents. Living Room: The living room has ample seating, a non-slip rug, a TV, additional seating, and a desk for computer use and activities. The common area is well maintained and provides space for recreation and socialization. Laundry Room: A washer, dryer, cabinet storage, and a secured exterior door leading to the garage are present in the laundry area. Laundry supplies are stored securely and are inaccessible to children. Garage: The garage contains extra laundry storage, a water heater, a water filter, and an exterior door providing access to the outside. The garage remains locked and is not used as a living space. Emergency & Activity Areas: The emergency closet holds a fully stocked first aid kit and emergency disaster kits. The activity room includes seating, a TV, a game machine, two swings, activity shelving, and secured hygiene storage. The office contains seating, a desk, locked storage for client belongings, a secured dresser for client files, and a designated area for medication storage and administration. Medications are stored securely in compliance with licensing requirements. Exterior: The outdoor space features seating, umbrellas, an air conditioning unit, and fruit trees. Trash is stored outside, and the exterior is clear and free of debris. There are no hazardous conditions observed in outdoor play areas. Health & Safety Compliance: A secured closet holds chemicals and cleaning supplies. Fire and carbon monoxide alarms were tested and found operational. Fire extinguishers are located in the kitchen and hallway. Sprinklers are installed throughout the home. All safety features meet group home regulations. Inspection Findings: No deficiencies were observed. The home remains in substantial compliance with licensing regulations. Exit Interview: An exit interview was conducted with the administrator, and a copy of this report was emailed to them.

met_with: Audrey Hughes


summary: Facility Evaluation

raw_content:
Narrative:
On 10/2/25 at 10: AM Licensing Program Analyst (LPA) Reagan Cohen made an unannounced visit to FTBP Opportunities Home for Children Group Home for the purpose of an annual/Random inspection. LPA met with Facility Manager Melissa, Administrator Audrey Hughes came to the facility later. A tour of the home was conducted.The facility is licensed to provide care and supervision services for four (4) children, ages 3-17 years old, ambulatory and non-ambulatory. The census today is 3. Two of the clients are non verbal one is verbal. The facility is set up as follows: There are four bedrooms and three bathrooms. There are no bodies of water on the premises and no security bars on windows and windows are operational. There are four fully charged fire extinguisher in the house. There are dual smoke/carbon detectors in each bedroom. Entry Way: In the entry way posted in a prominent public place are copies of the facility license, personal rights, facility sketch, activity schedule, weekly menu, & grievance procedures. Bedroom #1: Located at the front of the house adjacent to the entry way is bedroom#1. This room is used by a client. There is adequate lighting, a fan, AC, a TV, drawers, a closet, a bed, pillows, sheets, towels, and a blanket. There is a table with a chair. There is a window with a screen in good condition. The client in this room has AWOL tendencies so there is an alarm on the window to alert when it opens. The alarm system inadvertently prevents the window from fully opening. LPA addressed this with staff who said they would remove the alarm. Bathroom#1: Located adjacent to bedroom#1. This bathroom is for clients and guests. LPA observed and tested the toilet, shower, and sink. The sink temperature was tested to be 105 degrees F. Closet #1: There is a closet next to bedroom #1 and Bathroom #1. The closet is locked and inaccessible to clients. The cloest is storage for cleaning solutions. Kitchen: The kitchen are is after the entry way. The kitchen is complete with a fridge/freezer unit adequately filled with perishable food.The refrigerator operating temperature at 38 degrees and freezer at 0 degrees. There is a pantry filled adequately with non-perishable food. LPA observed that food is not contaminated and labeled with expiration dates. LPA observed an adequate amount of plates, cups, bowls, and utensils. The sharps are locked in a case which is also locked in a cabinet. The cabinet under the sink is locked storing cleaning solutions. LPA observed an operational stove and oven. The stove knobs were covered and made inaccessible to clients for their safety. LPA observed the disaster plan posted in the kitchen. Dining Area: The dinning area is open and connected to the kitchen. The dinning area included a table with adequate seating for the clients. Living room: The living room is open and connected to the dinning area. The living room has adequate seating with couches, a TV, and an armoire closet for storage. Bedroom #2: Located down a hallway after the dinning area. This room is used by a client. It contains a twin bed, drawers, desk, ceiling fan and adequate closet space. There is adequate lighting, a fan, AC, a TV, drawers, a closet, a bed, pillows, sheets, towels, and a blanket. There is a table with a chair. There is a door that leads to the front yard that is unlocked for emergencies. There is an alarm attached to the door to alert staff when it opens. Bedroom #3: Located next to bedroom #2. This room is unused. It contains a twin bed, drawers, desk, ceiling fan and adequate closet space. There is adequate lighting, a fan, AC, a TV, drawers, a closet, a bed, pillows, sheets, towels, and a blanket. There is a table with a chair. There is a door that leads to the front yard that is unlocked for emergencies. There is an alarm attached to the door to alert staff when it opens. Bathroom #2: This is a non-ambulatory bathroom and contains functioning toilet, sink and walk-in shower with running water Closet #2: This closet is unlocked and used to store the first aid kit. Laundry Room: Contains washer/dryer, cabinet space and secured exterior door to the garage. The cleaning solutions are kept locked and inaccessible to clients. Garage: The Garage is kept locked and inaccessible to clients. The facility vehicle is stored here. LPA observed the facility vehicle insurance and registration. Bedroom #4: Located after the hallway. This room is used by a client. There is adequate lighting, a fan, AC, a TV, drawers, a closet, a bed, pillows, sheets, towels, and a blanket. There is a table with a chair. There is a window with a screen in good condition. The window is able to open as an emergency exit. Den: This room is located after bedroom #4. This room has a table with adequate seating. There are couches for extra seating. There is a TV and games/activities. Office: There is a locked office after the den. The office is for staff only. The office holds all staff and client files. The office holds clients medication and the logs. The office has a desk, chairs, and computer. The office has cabinets for files and paperwork storage. Closet #3: This closet is kept locked and inaccessible to clients. The closet holds cleaning solutions and extra toiletries. Bathroom #3: This bathroom has a double sink with water temperature measured to be 108 degrees F. This bathroom is for clients. LPA observed a working toilet and shower. Backyard: The facility has a back yard that is accessed through the living room. The backyard has adequate amount of space for clients to run around. There is basketball hoop and a tetherball set. There is a shaded area under a canopy. The area is clear of debris and safe. LPA started the CARE Tools Checklist. LPA requested and received a copy of the client and staff roster, a copy of SIR's showing logs of previous restraint incidents, and a copy of the Board of Director Meeting Minuets. LPA observed copies of previous CCL reports. LPA observed the client medications and the MAR logs. LPA observed that client medications are stored separately and locked in the office. LPA observed the facility emergency drill log. LPA observed the staff training log. LPA will return to continue the inspection, reviewing the staff and client files, conducting staff and client interviews and completing the CARE Tools Checklist. No deficiencies cited at this time. A copy of this report was given to the administrator.

met_with: Facility Manger Melissa Shaprio


summary: Facility Evaluation

raw_content:
Narrative:
On 10/8/ Licensing Program Analyst (LPA) Reagan Cohen made an unannounced visit to FTBP Opportunities Home for Children Group Home for the purpose of continuing an annual/Random inspection. LPA met with Facility Manager Melissa. LPA continued the CARE Tools Checklist. LPA preformed a client and staff files review and documented on LIC 858 and LIC 859. LPA will return to interview staff and clients, and complete the CARE Tools Checklist. No deficiencies cited. Exit interview conducted. A copy of this report was given to the facility.


summary: Facility Evaluation

raw_content:
Narrative:
On 10/15/ Licensing Program Analyst (LPA) Reagan Cohen made an unannounced visit to FTBP Opportunities Home for Children Group Home for the purpose of continuing an annual/Random inspection. LPA met with Facility Manager Melissa. LPA continued the CARE Tools Checklist. LPA observed clients TB test was administrated on 10/15/25. LPA was informed that staff signature was not yet obtained due to staff not returning to work yet. LPA conducted interviews with 2 staff and 3 clients. Facility will send proof via email of completed forms. LPA will then complete and send over a completed staff and client file check form. No deficiencies cited. Exit interview conducted. A copy of this report was given to the facility.


summary: Facility Evaluation

raw_content:
Narrative:
On 12/17/ Licensing Program Analyst (LPA) Reagan Cohen arrived at the above facility and met Melissa Shapiro Facility Manager with for the purpose of conducting a case management other visit. During a previous visit for complaint 34-CR-20250912082534, LPA cited the facility for having an odor in the facility due to dogs being in the facility. LPA wanted to talk to the facility about requesting a waiver to allow for service and therapy dogs to be allowed in the facility. LPA discussed with facility manager that the facility can request a waiver to allow for service and therapy dogs to be allowed in the facility. LPA advised to do the the facility must submit in writing a request for a waiver. The request should include an amendment to the program design that address the following topic including but not limited to: the determination for allowing dogs/animals into the facility, how the dogs will be cared for and pick up after in the facility, any restrictions that will be placed on dogs in the facility, what will happen if clients and/or staff are allergic to and/or afraid of dogs, how staff will ensure that their duties will be upheld while providing for a dog, and how the facility will continue to stay in compliance with all rules and regulations with dogs in the facility. Exit Interview conducted and a copy of this report was given to the facility manager.

met_with: Melissa Shapiro Facility Manager


facility_name: GROWTH EXTENDED, INC.

raw_content:
Investigation Findings:
13On 06/20/2022 at 9:30am Licensing Program Analyst (LPA) Bernice Karnsrithong arrived at the facility for the purpose of conducting a complaint investigation and delivering its findings. Health and safety risk assessment was conducted upon arriving. LPA Karnsrithong met with Janice Lewis, Medical Associate who granted access and tour of the facility. During the investigation of the allegations, staff was flirting with a minor in care, minors not receiving medications as prescribed, staff behavior is disruptive to minors in care, and facility not serving meals in a timely manner; LPA Karnsrithong conducted confidential interviews and reviewed documentary evidences. During the investigation statements from confidential interviews were consistent that the facility has extensive medical administration procedures and meal schedules are being followed through and monitored regularly. There were no witnesses to corroborate the allegations. Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that a violation occurred. Therefore, the allegations are unsubstantiated. Exit interview was conducted with Janice Lewis and a copy of this report will be provided. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: JoAunne Griffin LICENSING EVALUATOR NAME: Bernice Karnsrithong 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 1

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

met_with: Janice Lewis, Medical Associate


raw_content:
Investigation Findings:
13On 08/30/2024, Licensing Program Analysts (LPA's) C. White and J. Armstrong arrived at the facility for the purpose of concluding the investigation and to deliver findings. LPA's met with Administrator, John Lewis and discussed the allegations. During the course of this investigation, LPA interviewed pertinent parties and reviewed records. Confidential interviews and records did not produce corroborating evidence to support the allegations. Staff denied the allegations and stated a staff member was present at the hospital with the client, that staff was in constant communication with the hospital, and that clients are never left unsupervised. Additionally, Client statements did not produce corroborating evidence to support the allegations. Based on information obtained, the allegations are found to be unsubstantiated. Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove the alleged violation did or did not occur. Exit interview completed and a copy of this report was left with the Administrator. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Bernice Karnsrithong LICENSING EVALUATOR NAME: Charmetha White 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 1

met_with: Administrator - John Lewis


raw_content:
Narrative:
Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. Therefore, the allegations are unsubstantiated. No deficiencies are being cited at this time. Exit Interview was conducted, and a copy of this report was provided to the facility.

Investigation Findings:
13On 4/14/ LPA J. Armstrong and LPM E. Hernandez arrived at the facility at 2:00pm. The Licensee was not present and did not answer the phone. The Findings could not be delivered today. On April 15, Licensing Program Analyst (LPA) Justine Armstrong conducted an unannounced visit to Growth Extended Inc. to conclude the investigation of the above allegations and deliver the findings. LPA met with John Lewis the Administrator and together, they discussed the investigation details. It was reported Staff mismanaged residents' medication records, Staff did not give residents their medications as prescribed, Facility does not have a vehicle to transport residents, Staff did not ensure that facility has adequate food for the residents, and Staff did not adequately supervise residents. During the investigation, the Licensing Program Analyst (LPA) conducted confidential interviews and reviewed several documents, including vehicle insurance records, the client medication roster, grocery lists for the facility, and the staff and client roster. While conducting confidential interviews, there was not enough evidence to substantiate the allegations. One of the confidential interviews reported that they received their medication daily and noted that the only time they missed their medication was during a visit away from the facility. C1 also mentioned that plenty of food is always available and that the facility never runs out of supplies. Based on the information gathered from the confidential interviews and documentary evidence, the LPA concluded that the allegations were unsubstantiated. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Enrique M Hernandez LICENSING EVALUATOR NAME: Justine Armstrong 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 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION EL SEGUNDO CRP RO, N. Continental Blvd. #290b El Segundo, CA Facility Name: Growth Extended, INC.FACILITY NUMBER: VISIT DATE: 04/15/2025

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

met_with: John Lewis


summary: Facility Evaluation

raw_content:
Narrative:
On October 21, 2021 at 9:35, Licensing Program Analyst (LPA) Charmetha White arrived at Growth Extended, Inc. Group Home for the purpose of conducting an Annual Required Inspection. LPA met with Clinical Director, Joy Lewis and Administrator, John Lewis who granted access to the location and together a tour of the entire facility was conducted both inside and out. The facility is licensed to provide care and supervision services for six (6) children ages 12-17 years old, ambulatory only. The census at the time of the inspection was three (3). The program accepts Private Placement clients only. The facility is a two story 6-bedroom, 4-bathroom house which includes a Living room, Dining room, Kitchen, Laundry area, a Classroom, a Front office, Staffing offices, Meeting/Conference room, and a Backyard patio. The home is set up as follows: Living room: Is equipped with a piano, couch, and chairs. Dining room: Is equipped with a table with seating for 8 people. Kitchen: Is equipped with a round glass table with 4 chairs. There is a stove/oven with gas burners all operable, a refrigerator/freezer, a dishwasher, and a microwave. The home was observed to have one-week supply of non-perishable and two days of perishable foods, including nutritious snacks, and the weekly menu is posted. The trash can is equipped with tight fitting lid. Laundry area: Is located next to the kitchen. It is equipped with a washer/dryer, found to be in working order, and a locked storage cabinet containing all sharp knives, disinfectants, and cleaning solutions. The laundry room also has a door leading to the backyard. Den: Is located off the hallway and is used for group sessions. It is equipped with ample seating, bookshelves, and a TV. Individual client lockers are located near the backdoor right next to the classroom area. Front office: Is equipped with a desk, 3 chairs, a sofa, and a locked file cabinet. Meeting/Conference room: This room is located outside in the back of the home. It is equipped with a conference room table that has ample seating, a television, and a bathroom. Nurses Office: Is located along the hallway between the Den and the Kitchen, across from the bathroom. It is equipped with a desk, computer, chair, sofa, and locked cabinet where all prescribed medications are locked and centrally stored. Medications are accessible only to employees supervising stored medications. The facility does not have any medications that need to be refrigerated. Report continued on LIC 809C. Backyard patio: Is equipped with patio furniture and ample seating. Garage: has been converted into the facility's classroom. It is equipped with Bedrooms: The home has 6 bedrooms which are all located on the second floor. Three (3) rooms are used as client bedrooms, each of client bedroom is equipped with two twin sized beds, and there is adequate closet/drawer space in each room. The three remaining rooms are utilized as follows: two rooms are used as staff offices, and one room is used as a client therapy room. Bathrooms: The home has a total of 5 bathrooms. One bathroom located along the hallway between the den and the kitchen, the second bathroom is located next to the laundry room and it used for the staff, the third and fourth bathrooms are located on the 2nd floor of the home, and the fifth bathroom is located in the meeting/conference room found in the backyard of the home. All bathrooms were observed to be in good repair and working order. The hot water temperature was tested and found to be between 105-120 degrees (F). The smoke and carbon monoxide detectors were tested and found to be in working order. The first aid kit was checked and found to be complete. The home has 3 regulation fire extinguishers. There is a working telephone readily accessible. Overall LPA observed the home to be clean, safe, and sanitary. The front and backyard were clean and free of debris. Passageways, stairways, inclines, ramps and open porches are unobstructed. There are no firearms or dangerous weapons in the facility. There was no swimming pool or bodies of water located at the facility. The facility operates within license conditions and limitations including capacity limitations. LPA discussed and advised the Licensee to ensure the following: Children are supported and encouraged to participate in extracurricular activities. Children are allowed and encouraged to contact the licensing agency or the Foster Care Ombudsperson, in confidence, without threats or punishment for making complaints. Children are accorded dignity in personal relationships with others in the home. LPA reiterated the importance of submitting Special Incident Reports and reporting all changes within the facility to Community Care Licensing and any other appropriate agency. All posting requirements for Group Home Licensure and Emergency Plan were met. The Program has a total of six Staff. LPA reviewed six Staff files. LPA observed all Staff records included annual personnel performance evaluations, all staff have met the education and experience requirements, and have completed the required trainings. All staff that work directly with clients have current First Aid/CPR cards in their files. LPA will return on a later date to complete review of client files and conduct client and staff interviews. There were no deficiencies noted on this date. An exit interview was conducted and a copy of this report was signed and left with the Clinical Director.


summary: Facility Evaluation

raw_content:
Narrative:
On October 22, 2021 at 9: AM, Licensing Program Analyst (LPA) Charmetha White arrived at the above location for the purpose of reviewing client records and to conduct staff and client interviews in order to complete the STRTP Annual Required Inspection which began on 10/21/2021. LPA met with the Clinical Director, Joy Lewis and Administrator, John Lewis who granted access to location and provided the files. The Program has a three clients. LPA reviewed all client files, conducted interviews with all three clients and four staff. This inspection included an overview of required Core Services and Supports and based upon inspection of facility records and interviews of staff and clients. LPA discussed the following with the Facility Manager: Incident reporting, including incidents related to Law Enforcement contacts as well as incidents involving Emergency Intervention. Discussed procedures for CFT (Child and Family Team) meetings. Licensee is meeting all requirements. There were no deficiencies noted on this date. An exit interview was conducted and a copy of this report was signed and left with the Clinical Director.