facility_name: TAFT HOUSE

summary: Facility Evaluation

raw_content:
Narrative:
On November 22, 2021 at 12:58pm, Licensing Program Analyst (LPA) Daphne Edison made an unannounced visit to Taft House to conduct an annual required inspection at the above location. LPA met with Kenneth Cook, Administrator for facility inspection. The facility is licensed to provide care and supervision for six (6) children, ages 12-17 years old, ambulatory only. The census on the date of this visit is three (3). There is no swimming pool or bodies of water on the premises. This is a three-story facility with a living room, dining room, kitchen, staff offices, four (4) bedrooms and four (4) bathrooms. First Floor Dining Room: Well equipped with the proper essentials including a table with six (6) chairs. Living Room: Consists of an entertainment area (TV, computers, etc.) and couches for residents. Kitchen: Equipped with refrigerator, 4 burner gas stove, oven, and microwave. There is adequate perishable and nonperishable food supply. Facility provides nutritious snacks between meals. Bathroom #1: Clean and operable at the time of the visit. Hot water kept at a safe temperature. Staff Office: Has all essentials for resident's medication storage and knife storage. Backyard: Has no debris or hazardous materials. Continued on LIC 809-C The home was inspected, and the following was observed: The home is clean, safe, and sanitary. Sharp knives, disinfectants/cleaning solutions, and medicines are made inaccessible to the children. Hot water kept at a safe temperature. The beds have comfortable mattresses, clean linens, blankets and pillows, all in good repair. Caregiver maintains a safe and comfortable temperature in the home. First aid kit was checked and found to have appropriate supplies. Fire extinguishers were fully charged. All smoke detectors and carbon monoxide detectors tested audible and were working properly. Emergency numbers, facility license, evacuation plan, and first aid information were posted. No guns or weapons are in the home. There is a working telephone readily accessible to clients in the home at all times. Children's Personal Rights and house rules are posted. Outdoor activity space is free of obstruction. LPA requested and was provided with a copy of the LIC 500, client roster, and activity schedule by the administrator. No deficiencies were cited. An exit Interview was conducted, and a copy of this report will be emailed to the facility.

met_with: Kenneth Cook


state: CA

summary: Facility Evaluation

raw_content:
Narrative:
On November 29, 2021 at 9:45am, Licensing Program Analyst (LPA) Daphne Edison made an unannounced visit to Taft House to conduct a case management continuation annual inspection which took place on November 22, 2021 at the above location. LPA met with Ashley Taylor, Program Manager for facility inspection. The facility is licensed to provide care and supervision for six (6) children, ages 12-17 years old, ambulatory only. The census on the date of this visit is three (3). There is no swimming pool or bodies of water on the premises. During this visit, LPA conducted 1 client interviews and reviewed 3 client Records which contained copies of the Needs and Service Plans and Medical Authorizations signed by each child and their authorized representative. Children in care are supervised and protected at all times. Children are accorded dignity in personal relationships with staff and others. Children can contact the licensing agency or Foster Care Ombudsperson in confidence without threats or punishment for making complaints. It was report by Facility Manager that children attend school, extracurricular, cultural and personal enrichment activities. Continued on LIC 809C LPA conducted 4 staff interviews and reviewed 10 staff Records and found facility personnel meet staff qualifications. LPA request training log for all staff at the facility. Caregiver(s)/adults working/residing in the home have DOJ/FBI criminal record clearances and Child Abuse Index Checks. Emergency Mass Disaster Casualty Plan was available for review. 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. The home is operating within the capacity and limitations of the license. The facility vehicle used to transport clients was observed by LPA to be in good repair and has current and valid California vehicle registration and insurance. LPA requested and received current activity schedule, weekly allowance log, and CARF accreditation. Facility cited for violation of California Code of Regulations, Title Division Six, regulation 80069(c)(1), Client Medical Assessment. The results of an examination for communicable tuberculosis and other contagious/infectious diseases is missing from client records. An exit Interview was conducted, and a copy of this report will be emailed to the facility.

report_type: Facility Evaluation

visit_type: Case Management

met_with: Ashley Taylor - Program Manager


summary: Facility Evaluation

raw_content:
Narrative:
On October 24, 2023 at 12pm Licensing Program Analyst (LPA) Donald Martin arrived at the above facility. The purpose of the visit is to conduct an Annual/Required Inspection of the home. LPA was met by Program Manager, Ashley Taylor and allowed into the facility. The facility is licensed to provide care and supervision for six (6) children, ages 12-17 years old, ambulatory only. There were no clients present upon LPA's arrival. There is no swimming pool or bodies of water on the premises. This is a three story facility which also has a basement (For storage only), staff offices, four (4) bedrooms and four (4) bathrooms. The First Floor was well decorated with the Halloween theme. Inside The Dining Room area, is a dining room table with 8 chairs. There is a book shelf with several books and two locked patio access doors. TheLiving Room has an entertainment area with a TV attached to the wall a computer, couch and two chairs. Behind the living room is the staff office which has two desks and two computer. The Kitchen is equipped with a refrigerator, stove, and microwave. Burners on the stove are in good working conditions. There is also two additional refrigerators in a small room right outside of the kitchen. There was an adequate perishable and non-perishable food supply. Behind the kitchen is the Laundry Room. The laundry room has a washer and dryer, locked storage space for the detergent and a locked walk in pantry filled with food. Adjacent to the kitchen is a small room with a TV, chairs and games for the clients. There are Bedrooms on the second floor. Each bedroom has two twin beds, two dressers, and a large closet. Note: Bedroom #2 is said to be a separation room and is only used for that purpose. Program Manager, Ashley Taylor stated that the house never goes above the 6 client capacity. There are two newly remodeled full sized Bathrooms on the second floor for the clients use. The home does not work with a signal system, however LPA was informed that no clients are allowed on the second floor without staff presence. There is a desk located upstairs by the stair case for staff to supervise clients while on the second floor. Cont 809-C There is an emergency exit door that leads down to the side of the house in case of emergencies. There is a locked cabinet for linen and a locked closet for clients emergency backpacks and other supplies. There is an access door that leads to an upstairs patio and an art room. This area is locked and can only be used by clients with staff supervision. The Third Floor has 4 staff offices and is inaccessible to clients. The Backyard is very spacious and free of debris and hazardous material. There is a seating area, a garden, and an area with a basketball hoop, On the side of the house are the shut off valves. Overall, the home is clean, safe, and sanitary. Sharp knives, disinfectants/cleaning solutions, and medicines are made inaccessible to the children. Hot water kept at a safe temperature. The beds have comfortable mattresses, clean linens, blankets and pillows, all in good repair. Caregiver maintains a safe and comfortable temperature in the home. First aid kit was checked and found to have appropriate supplies. Fire extinguishers were fully charged. All smoke detectors and carbon monoxide detectors tested audible and were working properly. Emergency numbers, facility license, evacuation plan, and first aid information were posted. No guns or weapons are in the home. There is a working telephone readily accessible to clients in the home at all times. Children's Personal Rights and house rules are posted. LPA will return to review the files and interview staff and clients with in 7 days. There were no deficiencies cited at the time of the visit.

visit_type: Annual

met_with: Ashley Taylor-Program Manager


facility_name: TARZANA TREATMENT CENTERS

summary: Facility Evaluation

raw_content:
Narrative:
On May 31, 2022, at 9:15am, Licensing Program Analyst (LPA), Enrique Hernandez conducted an unannounced inspection, at the above-said facility, for the purpose of conducting an Annual/ Random Inspection. LPA Hernandez met with Theresa Scott Facility Administrator (FA) who granted access into the facility and provided a tour of the entire facility, inside and out. Facility is single story 40 bed capacity building. Bedrooms with two twin beds inside each room and 11 client restrooms. There are currently 13 clients residing in the facility. There are no bodies of water on premises. LPA observed the following during inspection: Administration Offices: A secured entrance door of the facility building grants access to a lobby area with two couches, a bathroom and reception area. Bedrooms: There are 20 bedrooms in the building all are equipped with two (2) twin size beds. There are adequate drawers, closet space, a desk and lighting in the rooms. Bathrooms: The facility has a total of 11 half bathrooms and one room with two showers and another room with 4 showers Kitchen located adjacent to the dining room, equipped with one (1) commercial refrigerator and one (1) commercial size freezer, one (1) toaster ovens, one (1) stove with six burners, two (2) ovens, one (1) microwave, trash can with lid, ice maker machine, a fryer and fire extinguisher. Dining Area: There are two dining areas with plenty of seating also a pool table is in one of the dining areas. Outdoor: LPA also observed an outdoor basketball court next to the facility entrance. LPA observed the Surrounding fencing the Continue on LIC809-C Laundry room: There are two (2) washers and Two (2) dryers in a locked hallway room with cleaning supplies and detergent that only staff have access to enter. Therapy Room: Are used for therapy and counseling for clients equipped with a tv two tables and 10 chairs. Located inside the facility. At the time of the inspection, the facility was clean, safe, sanitary and in good repair. FA confirmed that there are no firearms or dangerous weapons in the facility. All medications are stored in locked cabinets and are inaccessible to clients. There is an ample supply of perishable and non-perishable food in the facility. The facility ensures three nutritious meals, snacks, and special diets. There is a private chef that comes to the facility and prepares all meals for the clients. All smoke detectors were tested and operable at the time of inspection. Multiple fire extinguishers were observed throughout the facility that were tested and operable at the time of inspection. LPA was able to count a total of 17 facility cameras on the premises, which include 5 exterior cameras, 12 indoor. All facility cameras were visible, functional. LPA will look for the waiver in the facility file. The facility administrator provided LPA with the following: Policies and Procedures regarding the cameras, Conditions of admission and informed consent for surveillance cameras, LIC 500 and the client roster Facility Administrator will email it to LPA Hernandez. Due to time constraints, LPA will return to review the client/staff files in order to complete the Annual/ Random Inspection. Per California Code of Regulations, Title Regulations, Division 6, Chapters 1 & 5, there are no deficiencies to be cited at this time. Exit Interview conducted, and a copy of this report will be emailed to the facility due to technical difficulties with LPA's printer.

met_with: Theresa Scott


summary: Facility Evaluation

raw_content:
Narrative:
On 05/16/2024, at 9:45am, Licensing Program Analyst (LPA), Jhane Haynes conducted an unannounced inspection, at the above facility, for the purpose of conducting an Annual/Random Inspection. LPA Haynes met with Facility Administrator (FA) Theresa Scott who granted access into the facility and provided desk to conduct file review. LPA reviewed five clients files. Client files are secured and centrally stored in staff office. LPA observed immunization records, treatment plan, medical record and facility intake forms to be maintained in client files signed by client and/or client's authorized representative. LPA also reviewed five staff files. Staff files maintained snapshot of completed training, First Aid/CPR certifications, health screening and job duties. All reviewed staff have obtained criminal record clearance with DOJ, FBI and CACI. LPA observed record of fire drills done within the last 12 months. Due to time constraints, LPA will return at a later date to complete annual inspection. No deficiencies will been cited at this time. An exit interview was conducted and a copy of this report was left with facility administrator.

met_with: Theresa Scott Facility Administrator (FA)


summary: Facility Evaluation

raw_content:
Narrative:
On 06/18/2024 at 9:45AM Licensing Program Analyst(LPA) Jhane Haynes conducted an unannounced visit for the purpose of continuing an Annual/Random Inspection initiated on 05/16/24. LPA Haynes met with Facility Administrator (FA) Theresa Scott who granted access into the facility and provided a tour. This is a 20-bed co-ed facility. LPA observed the following: Kitchen is equipped with functional kitchen appliances not limited to; stove, microwave, oven, and multiple commercial refrigerators with perishables for at least up to two days. Refrigerators are kept at 45 degrees and freezers do not exceed 0 degrees. There's a kitchen pantry with non-perishables for up to a week. Dining contains adequate seating for clients in care. Drink stations, salad bar, weekly menu, and health permits is also posted here. There's also a secured storage area for client snacks upon intake, restrooms, and compost/trash bins. There is a TV the youth share. Maintenance Room is inaccessible to clients. It contains hardware and electrical. Custodial Closet is inaccessible to clients and contains cleaning supplies. Activity Room is adjacent to the dining area and contains additional seating, pool table and drink machines. Lobby contains required postings not limited to, license, grievance procedures, and personal rights. There are two restrooms and reception window. Group Room contains seating for clients, TV, and shelves for clients to attend group. Laundry Room contains two washers and dryers. There is a secured cabinet for laundry supplies. FA states clients are supervised when using laundry room. Storage Closets there are four closets located throughout the hallway. Each contains additional linen and paper supplies. Bedrooms There are 20 bedrooms on site. Each bedroom is equipped with two twin beds with drawers, a desk and two closets. There are half bathrooms adjoining two bedrooms equipped with function toilet and sink. (Continued on LIC809-C) The bedrooms are not co-ed and contain smoke detectors in every room. Four bedrooms are used for additional facility storage due to not operating at full capacity. Shower rooms There are 2 shower rooms with a total of six shower stalls total. Med Room contains LVN desk, secured cabinets for medication storage, first aid kit with required supplies, medication logs, med disposal, and mini refrigerator. Exterior contains rec yard, basketball court and water fountains. The perimeter is secured with gates. Outside gates is where utility shut off are located. Exterior is free of debris or hazards. Staff Office/Reception contains seating for staff, secured staff and client files, and reception desk. There are fire extinguishers and emergency exits located throughout the facility. Windows are equipped alarms if opened. Cameras are located in facility common areas. LPA conducted interviews with three staff and four clients. The facility is safe, sanitary and in good repair. No deficiencies will been cited at this time. An exit interview was conducted and a copy of this report was emailed to the facility administrator.


summary: Facility Evaluation

raw_content:
Narrative:
On May 19, 2026, at 10:00am, Licensing Program Analyst (LPA), Wendely Moodie-Naranjo conducted an unannounced inspection, at the above-said facility, for the purpose of conducting an Annual/ Random Inspection. LPA Moodie-Naranjo met with Theresa Scott Facility Administrator (FA) who granted access into the facility and provided a tour of the entire facility, inside and out. Facility is single story 40 bed capacity building. Bedrooms with two twin beds inside each room and 11 client restrooms. There are currently 19 clients residing in the facility. There are no bodies of water on premises. LPA requested client and staff rosters. LPA observed the following during inspection: Administration Offices: A secure entrance door of the facility building grants access to a lobby area with two couches, two bathrooms and reception area. Bedrooms: There are 20 bedrooms in the building, all are equipped with two (2) twin size beds. There is adequate drawers, closet space, a desk and lighting in the rooms. Bathrooms: The facility has a total of 11 half bathrooms and one room with two showers and another room with 4 showers. Kitchen located adjacent to the dining room, equipped with one (1) commercial refrigerator a and one (1) commercial size freezer, one (1) stove with six burners, two (2) ovens, one (1) microwave, trash can with lid, ice maker machine, a fryer and fire extinguisher. Dining Area: There are two dining areas with plenty of seating also a pool table is in one of the dining areas. Outdoor Area: contains rec yard with a basketball court and water fountains next to the facility entrance. Outside gates is where utility shut off are located. Exterior is free of hazardous debris. Continue on LIC809-C First Aid Kit: Kit inspected and complete Laundry room: There are two (2) washers and Two (2) dryers in a locked hallway room with cleaning supplies and detergent that only staff have access to enter. FA states clients are supervised at all times during laundry time. Therapy Room: Are used for therapy and counseling for clients equipped with a tv two tables and 10 chairs. Located inside the facility. At the time of the inspection, the facility was clean, safe, sanitary and in good repair. FA confirmed that there are no firearms or dangerous weapons in the facility. There is an ample supply of perishable and non-perishable food in the facility. The facility ensures three nutritious meals, snacks, and special diets. There is a private chef that comes to the facility and prepares all meals for the clients. Smoke detectors were tested and operable at the time of inspection by the maintenance staff. Multiple fire extinguishers were observed throughout the facility that were tested and operable at the time of inspection. Due to time constraints, LPA will return to review the client/staff files and medicine room in order to complete the Annual/ Random Inspection. Per California Code of Regulations, Title Regulations, Division 6, Chapters 1 & 5, there are no deficiencies to be cited at this time. Exit Interview conducted, and a copy of this report will be electronically sent to Facility Administrator.

met_with: Theresa Scott-Facility Administrator


facility_name: TEEN HARBOR

summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA), Lidia Tinoco met with Sreekanth Chava and Gurjeet Singh at the Fresno Regional Office for the purpose of discussing the application that is currently being reviewed. LPA was provided with a copy of the Zoning Determination. Facility Physical plant was discussed and Licensee will provide an updated document to LPA. Administrator qualifications were discussed. An electronic copy of the program statement was requested.

met_with: Sreekanth Chava, Gurjeet Singh


summary: Facility Evaluation

raw_content:
Narrative:
On May 28, 2025, Licensing Program Analysts (LPA) Olivia Medrano and Briana Placencia met with Licensees Gurjeet Singh and Sreekanth Chava, Teen Harbor for the purpose of a Technical Assistance meeting and Component II. New Administrator was discussed and associating all staff and one board member to Guardian. Administrator and House manager qualifications were provided to LPAs. Fire clearance was provided by licensee. Vehicle information and requirements for staff flies was discussed. The pool was discussed, licensee stated the pool is less than five feet deep and has a fence. Staff water safety requirement was also discussed. Incident reporting was also discussed. LIC 500 will be updated and provided to LPAs. Kevin Robertson, Compliance Coordinator joined the meeting via phone. Licensee requested an extension for revisions until June 6, 2025. A LIC Financial Verification was provided to Licensee and will be returned by June 6, 2025. Types of Licensing Visits: ~Pre Licensing ~Post Licensing ~Annual unannounced ~Complaint unannounced ~Plan of Correction unannounced ~Case Management unannounced

met_with: SINGH,GURJEET


summary: Facility Evaluation

raw_content:
Narrative:
On August 13, 2025, Licensing Program Analysts (LPAs) Olivia Medrano and Les Inouye conducted a pre-licensing inspection at Teen Harbor Group Home located in Fresno, CA. LPAs met with Gary Singh, Licensee/Administrator, Sreekanth Chava, Licensee/Administrator, Silvia Rios, (waiting for administrator certificate), and Diane Navarro (needs to be cleared still). A physical plant inspection was completed inside and outside of the facility. The home has five bedrooms, an office, separate medication storage closet, living room, sitting room, kitchen, dining room, game room, and two conference rooms. The medication closet has six separate locking safes, refrigerator, and binders prepared for medication records. Sharps are locked in pantry and cleaning solutions locked in laundry room. The home has two fire extinguishers serviced in April 2025 and one in the shed. There was a one week sample menu posted and plenty of seating for clients and staff. The facility has a solid fence surrounding the property and two drive-thru gates to access the home. The facility has an in ground pool with fence surrounding it. The facility has a sign designating the evacuation area away from the facility. LPAs discussed window coverings for privacy in client bedrooms, staff files, transportation, finances, cameras, hygiene, first aid kit, and physical plant issues that licensee will be addressing before LPAs next visit.

visit_type: Prelicensing

met_with: Gary Singh


summary: Facility Evaluation

raw_content:
Narrative:
On September 15, 2025, Licensing Program Analysts (LPAs) Olivia Medrano and Vanessa Galvan conducted a follow up to the pre-licensing inspection initiated on August 13, 2025, at Teen Harbor Group Home located in Fresno, CA. LPAs met with Gary Singh Licensee/Administrator. A physical plant inspection was completed inside and outside of the facility. LPAs observed window covering in all bedrooms, hygiene in individual caddies, and first aid kit has a thermometer. The main pool gate has two gates that open and one side is secured with a keyed padlock. The other gate and back pool gate opens from the inside and has a code to enter from the outside. LPAs reviewed staff files that are in progress as well as client files. This report was discussed and provided to Gary Singh at the conclusion of the inspection.


summary: Facility Evaluation

raw_content:
Narrative:
On February 12, 2026, Licensing Program Analysts (LPAs) Olivia Medrano and Vanessa Galvan traveled to Teen Harbor Group Home (GH) located in Fresno, CA for the purpose of completing Component III. Present at the meeting: Licensee Gurdeet Sing and Sreekanth Chava, Administrator Silvia Rios, Trainer Gina Hernandez, Director of Business Development Paige Williams. LPAs discussed general and program specific regulations and requirements with the facility representatives. LPAs and staff discussed a new application in order to change or remove Licensee. Gate access was also discussed from inside or outside of the facility. LPA will provide to the facility: link to CCL reporting email, link to GH regulations, and links to LIC forms. An exit interview was conducted and a copy of this report was left at the GH.

met_with: Silvia Rios


summary: Facility Evaluation

raw_content:
Narrative:
On March 2, 2026, Licensing Program Analysts (LPAs) Olivia Medrano and Licensing Program Managers Vanessa Galvan and Lourey Bartolome met with Gurdeet Singh and Sreekanth Chava, Administrator Silvia Rios, Director of Business Development Paige Williams. LPM Bartolome discussed the the changes of the Administrative Organization and the required documents needed to implement the changes. LPM requested the board review their by laws and submit board minutes stating the changes. CCL requested an updated LIC308 and LIC309 and a copy of the board minutes.

met_with: Gurdeet Singh and Sreekanth Chava


facility_name: TEEN PROJECT, INC., SANCTUARY RECOVERY CENTER, THE

summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
Based on confidential interviews and record review that staff allowed minor (C1) to use nicotine may have occurred, however, is not supported or proven by evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, appeal rights were explained, and a copy of this report and LIC 811 was provided to facility designee.

Investigation Findings:
13On October 20, 2025, at 10: AM, Licensing Program Analyst (LPA) Guadalupe Munoz met with facility representative, Lora Caldwell , to discuss the investigative finding for the allegation noted above. LPA conducted an inspection of the facility on 04/10/25 at 10:00 am and no deficiencies were observed. LPA interviewed four Staff (S1-4), Social Worker (SW) and attempted to interview one Client (C1). During the investigation, the following documents were reviewed: Facility documents, staff file, and client file. On 04/02/25, Community Care Licensing (CCL) received an allegation that staff allowed minor to use nicotine. Specifically, it was stated that C1 was allowed to use nicotine vape while being transported back to the facility with S1. Interviews confirmed that on the night of the alleged incident, S1 was transporting C1, and C1 and S1 were alone in the car. Interviews revealed conflicting statements as to whether or not staff allowed minor to use nicotine during the drive to the facility. There were no witnesses to confirm or dispute the allegation. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Guadalupe Munoz 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 22-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION ORANGE COUNTY RO, THE CITY DR., Suite Orange, CA Facility Name: Teen Project, INC., SANCTUARY RECOVERY CENTER, THEFACILITY NUMBER: VISIT DATE: 10/21/2025

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

report_type: Complaint Investigation

met_with: Lora Caldwell

complaint_status: unsubstantiated


summary: Facility Evaluation

raw_content:
Narrative:
On January 26,2023, at 11: AM, Licensing Program Analyst (LPA) Guadalupe Munoz conducted a Group Home pre licensing inspection. LPA Munoz met with Jewelana Kayanan, Program Director (PD), Anasheh Safarian, Director of Operations/Back-Up Administrator,Lora Caldwell, Administrator, and Executive Director, Lauri Burns. The facility is a single-story residential building with five bedrooms, three client bathrooms, staff office with a staff restroom, kitchen, dining area, laundry area with a washer and dryer, living room, family room and a classroom/group room to conduct group therapy. There is a two-car garage that is attached and used for back up storage. The staff office is where the facility stores medications, sharps and funds that are stored within a locked cabinets. The office is kept locked when not in use and is only accessible to the facility staff. Personnel files are kept in the Human Resources office which is located in Los Angels. LPA advised licensee to ensure accessibility of files during an unannounced visit. Client files are stored electronically and a hard copy located in Administrator office. A physical plant inspection was completed and included the following checks: Facility grounds are clean and free of debris, observable hazards, and insects. There is adequate indoor and outdoor activity space. Sports/workout equipment, and televisions were observed for client's recreation time. All facility smoke detectors and carbon monoxide detectors were tested and were observed to be in working order; fire extinguishers were properly charged and serviced. All of the required forms were posted in the facility that included: Weekly Menus, Personal Rights Poster and Emergency Disaster Plan. Each of the five client bedrooms has proper lighting, adequate drawer space, all six beds were observed with appropriate clean linens, pillows, blankets, comforters, mattress pads, and mattresses in good repair. **See Continuation on Page 2** The bedrooms are as follows: Bedroom #1: two full size beds with a desk and two closets. Bedroom is designated for two clients. Bedroom #2: one full size bed with a desk and closet. Bedroom is designated for one client. Bedroom #3: one full size bed with a desk and closet. Bedroom is designated for one client. Bedroom #4: one full size bed with a desk and closet. Bedroom is designated for one client. Bedroom #5: one full size bed with a desk and closet. Bedroom is designated for one client. Two bathrooms are located in the hallway and bedroom #4 and #5 have a shared bathroom that can be accessed from both bedrooms. There is ample storage areas for client's personal property. There is a linen closet with extra bedding and towels for client use and a closet for clients personal hygiene items and supplies. There is a locked storage closet for cleaning supplies in the hallway. The hot water meets the required range of 105-120 degrees Fahrenheit. The facility has a fully equipped first aid kit and a current first aid manual approved by the American Red Cross. One first aid kit is located the hallway leading to bedroom 4 and 5 and one first aid kit is located in staff office. Per Administrator, no firearms or weapons are kept or allowed in the facility and smoking is prohibited. Administrator was advised that this pre-licensing report will be reviewed by the Department. The facility will be notified once they are provisionally licensed as a Group Home. An exit interview was conducted with Anasheh Safarian, Director of Operations/Back-Up Administrator and Lora Caldwell, Administrator. A copy of this report was provided to the facility for signature. The original signed report will be in the facility file.


summary: Facility Evaluation

raw_content:
Narrative:
On March 27,2024, at 10: AM, Licensing Program Analyst (LPA) Guadalupe Munoz conducted a Group Home post licensing inspection. LPA Munoz met with Lora Caldwell, Administrator, and Andrea Carmona, Facility Manager/Program Director. A physical plant inspection was completed and included the following checks: Facility grounds are clean and free of debris, observable hazards, and insects. There is adequate indoor and outdoor activity space. Sports/workout equipment, and televisions were observed for client's recreation time. All facility smoke detectors and carbon monoxide detectors were tested and were observed to be in working order; fire extinguishers were properly charged and serviced. All of the required forms were posted in the facility that included: Weekly Menus, Personal Rights Poster and Emergency Disaster Plan. The facility is a single-story residential building with five bedrooms, three client bathrooms, staff office with a staff restroom, kitchen, dining area, laundry area with a washer and dryer, living room, family room and a classroom/group room to conduct group therapy. There is a two-car garage that is attached and used for back up storage. The staff office is where the facility stores medications, sharps and funds that are stored within a locked cabinets. The office is kept locked when not in use and is only accessible to the facility staff. Personnel files are kept in the Human Resources office which is located in Los Angels. LPA advised licensee to ensure accessibility of files during an unannounced visit. Client files are stored electronically and a hard copy located in Administrator office. LPA reviewed 5 staff files and 3 client files. LPA interviewed 2 staff and 2 clients during visit. Each of the five client bedrooms has proper lighting, adequate drawer space, all six beds were observed with appropriate clean linens, pillows, blankets, comforters, mattress pads, and mattresses in good repair. There is ample storage areas for client's personal property. There is a linen closet with extra bedding and towels for client use and a locked cabinet for clients personal hygiene items and supplies. There is a locked storage closet for cleaning supplies in the hallway. The hot water meets the required range of 105-120 degrees Fahrenheit. The facility has a fully equipped first aid kit and a current first aid manual approved by the American Red Cross. One first aid kit is located the hallway leading to bedroom 4 and 5 and one first aid kit is located in staff office. Per Administrator, no firearms or weapons are kept or allowed in the facility and smoking is prohibited. An exit interview was conducted and copy of this report and LIC 811 were provided to designee.


summary: Facility Evaluation

raw_content:
Narrative:
On February 19,2025 at 10: AM, Licensing Program Analyst (LPA) Guadalupe Munoz and LPA Stefani Mutialu conducted a Group Home annual inspection. LPAs met with Lora Caldwell, Administrator, and Andrea Carmona, Facility Manager/Program Director. A physical plant inspection was completed and included the following checks: Facility grounds are clean and free of debris, observable hazards, and insects. There is adequate indoor and outdoor activity space. Sports/workout equipment, and televisions were observed for client's recreation time. All facility smoke detectors and carbon monoxide detectors were tested and were observed to be in working order; fire extinguishers were properly charged and serviced. All of the required forms were posted in the facility that included: Weekly Menus, Personal Rights Poster and Emergency Disaster Plan. The facility is a single-story residential building with five bedrooms, three client bathrooms, staff office with a staff restroom, kitchen, dining area, laundry area with a washer and dryer, living room, family room and a classroom/group room to conduct group therapy. There is a two-car garage that is attached and used for back up storage. The staff office is where the facility stores medications, sharps and funds that are stored within locked cabinets. The office is kept locked when not in use and is only accessible to the facility staff. Each of the five client bedrooms has proper lighting, adequate drawer space, all six beds were observed with appropriate clean linens, pillows, blankets, comforters, mattress pads, and mattresses in good repair. There is ample storage areas for client's personal property. There is a linen closet with extra bedding and towels for client use and a locked cabinet for clients personal hygiene items and supplies. There is a locked storage closet for cleaning supplies in the hallway. ****** The hot water temperature was 108 degrees which meets the required range of 105-120 degrees Fahrenheit. The facility has a fully equipped first aid kit and a current first aid manual approved by the American Red Cross. One first aid kit is located the hallway leading to bedroom 4 and 5 and one first aid kit is located in staff office. Per Administrator, no firearms or weapons are kept or allowed in the facility and smoking is prohibited. Personnel files are kept in the Human Resources office which is located in Los Angels and made available to LPAs electronically. Client files are stored electronically and a hard copy located in Administrator office. LPAs reviewed 5 client files and 5 staff files during visit. An exit interview was conducted and copy of this report and LIC 811 were provided to designee.


summary: Facility Evaluation

raw_content:
Narrative:
On March 2, 2026, Licensing Program Analysts (LPA) Stefanie Mutialu arrived at the facility to conduct an interview with the client listed on the Confidential Names List (LIC 811) dated March 2, 2026, regarding an incident unrelated to this facility. LPA met with Administrator, Lora Caldwell, who granted LPA access to the facility. LPA conducted one client interview during this visit. An exit interview was conducted and a copy of this report, and Confidential Names (LIC 811), were provided to Administrator, Lora Caldwell. Due to technical difficulties this report was emailed to Administrator.

met_with: Administrator, Lora Caldwell


facility_name: TIJAY RENEE RESIDENTIAL

raw_content:
Narrative:
Confidential statements obtained indicate C1 was sexually assaulted by C2 on multiple occasions. Confidential statements reveal facility staff and other residents were unaware of any signs or neglect toward C1 to directly cause C1 to become sexually assaulted by C2. Information obtained indicates that C1 never notified or gave any signs to staff or other residents of incidents at any time while in care. Medical reports indicate no physical findings were found. Based on the timeline of the event from confidential statements and documentary records there is a lack of evidence to prove neglect/lack of supervision leading to C1 to be sexually abused by C2. Therefore, the allegation is deemed unsubstantiated. A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. There are no deficiencies cited at this time. Exit interview completed. A copy of this report and LIC811 was provided to Facility Administrator via email.

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

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

met_with: Renee Williams


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst Connie Jones-Steward arrived at the facility at 11: AM to conduct the annual/required inspection. LPA was granted admittance by staff Antoine Germany who conducted COVID protocols. The inspection began at 11: AM and the following was observed. This is a three bedroom home located in a residential section of the City of Los Angeles. There are no fireplaces or bodies of water. There are no firearms in the home. Yard space was free of hazards. The side gate that could block emergency exit from bedroom #1 remains unlocked, There are 4 clients in care. One client is 11 years old. He does not share a bedroom with anyone and has 1:1 supervision when he is awake. All knives, household cleaners and medications are safely stored. Hot water temperature is safe. Kitchen and bathroom equipment is in good working order. There is a good supply of food in the home. Smoke detectors carbon monoxide detectors are working and properly placed. Security bars are operational. All bedrooms have twin beds with mattresses and linens in good condition. There is adequate storage space for all clients. There is a complete first aid kit There were no deficiencies cited during this inspection. LPA will return at a scheduled date to review client and employee records and conduct the required interviews,

met_with: Renee Williams/Antoine Germany


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst Connie Jones-Steward arrived at the facility at 10: AM to conduct the annual/required inspection. The inspection began at 10: AM and the following was observed. This is a three bedroom, three bathroom home located in a residential section of the City of Los Angeles. There are no fireplaces or bodies of water. There are no firearms in the home. Yard space was free of hazards. The side gate that could block emergency exit from bedroom #1 remains unlocked. LPA observed a converted garage used as a storage area. The security bars on windows have quick release locks that are not blocked by furniture. LPA observed a backup generator on the premises. Smoke detectors & carbon monoxide detectors are working and properly placed. . There are 4 clients in care. One client is 12 years old. He does not share a bedroom with anyone and has 1:1 supervision when he is awake. All knives, household cleaners and medications are safely stored. Hot water temperature is safe. Kitchen and bathroom equipment is in good working order. There is a good supply of food in the home. All bedrooms have twin beds with mattresses, mattress covers and linens in good condition. There is adequate storage space for all clients. There is a complete first aid kit. LPA began review of the clients records. LPA will continue review of client and staff records at a later date. LPA will also interview staff at a later date. There were no deficiencies found on this date.

met_with: Renee Williams, CEO


summary: Facility Evaluation

raw_content:
Narrative:
LPA Connie Jones-Steward met with Administrator/CEO Renee Williams to complete the Annual Inspection. LPA reviewed employee files and discussed employee duties and experiences with staff. Clients are non-verbal. Therefore client interviews were not conducted. LPA found no deficiencies with the staff records. This concludes the Annual Inspection.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst Connie Jones-Steward arrived at the facility at 1: PM to conduct the Physical Plant portion of annual/required inspection. The inspection began at 2: PM and and was was conducted with the assistance of CEO Renee Williams, The following was observed. This is a three bedroom, three bathroom home located in a residential section of the City of Los Angeles. There are no fireplaces or bodies of water. There are no firearms in the home. Yard space was free of hazards. The side gate that could block emergency exit from bedroom #1 remains unlocked. LPA observed that the security bars on windows have quick release locks that are not blocked by furniture. Smoke detectors & carbon monoxide detectors are working and properly placed. All knives, medications and household cleaners are safely stored. The perpetual flame on the gas stove is secured away from clients. Hot water tested at 119 degrees. All bedrooms have two twin beds with linens in good condition. There is the required storage space for each client. The food supply meets Title 22 regulations for 1 week of fresh food and two weeks of non-perishable food on hand. The facility has a complete 1st aid kit. There were no physical plant deficiencies found. LPA will return at a future date to review records and conduct interviews.

met_with: Renee Williams, CEO; Leticia Ruiz. Secretary


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst Connie Jones-Steward conducted the review of staff and client records. The licensee was cited under 84064(e) Administrator Qualifications 84065(i) Initial Training, 84065(j) Annual training and 80065(f) Heath Related Services. LPA will return to verify correction at a future date.


summary: Facility Evaluation

raw_content:
Narrative:
On 5/16/25 at 10: AM Licensing Program Analyst (LPA) Reagan Cohen made an unannounced visit to Tijay Renee Residential Group Home for the purpose of an Annual/Required inspection. LPA met with Joann Madrigal and Administrator Renee Williams arrived after. A tour of the home was conducted. The facility is licensed to provide care and supervision services for six (6) clients ages 7-17 and the census today is three (3). The facility is set up as follows: There are four bedrooms and two full bathrooms and one half bathroom. There are no bodies of water on the premises. There is a living room, dinning room, and kitchen. There is an outside garage used for storage space. There is a front yard and back yard space. The facility uses cameras in its facility. There are 2 ramps that lead to the front and back entrances. Living Room/Dinning Area: There is a living room has a large L shaped sofa, ceiling fan, air purifier, AC unit and TV. There is a working fire extinguisher in both areas. The dinning are has a small dining table with 4 seats. A desk with storage, a storage dresser, and 3 filing cabinets for storage. This area leads to the kitchen and bathroom/bedroom #1. Kitchen: has a four (4) burner gas stove/oven (all burners were operational during the inspection), and a refrigerator /freezer. There is an adequate amount of perishable and non-perishable food. Sharp knives are made locked and inaccessible in a cabinet. Cleaning supplies and disinfectants are kept in a locked cabinet and made inaccessible to children in care. There is a working washer and dryer stack unit. There is adequate seating with 4 chairs and 2 counter tops spaces for eating. There is a fully charged fire extinguisher. The kitchen leads to bedroom #2 &#3, bathroom #2 & #3, and has access to the backyard. Bedroom #1: is reserved for two clients. It has two twin beds. It has closet and drawer space adequate for two. There is a smoke detector in the room. The windows open and the security bars open on the windows. There is a television, working lights, and an AC unit. Bathroom #1: bathroom is located along the hallway next to Bedroom #1. The bathroom contain a toilet, sink, and a shower. The hot water was tested and found to be with 100 degrees F. There are extra towels stored here. Office: Located next to bathroom #1. Has a desk, printer, and filing cabinets for storage. Bedroom #2: is reserved for two clients. It has two twin beds. It has closet and drawer space adequate for two. There is a smoke detector in the room. The windows open and the security bars open on the windows. There is a television, working lights, and an AC unit. There are no clients in bedroom #2 currently. Bedroom #3: is reserved for one client. It has two twin beds. It has closet and drawer space adequate for two. There is a smoke detector in the room. The windows open and the security bars open on the windows. There is a television, working lights, and an AC unit. Bathroom #2: bathroom is a half bath located along the hallway next to Bedroom #2 and Bathroom #3. The bathroom contain a toilet and sink. The hot water was tested and found to be with 103 degrees F. There are extra towels stored here. Bathroom #3: bathroom is a located along the hallway next to Bedroom #2 and Bathroom #2. The bathroom contain a toilet, shower, and sink. The hot water was tested and found to be with 115 degrees F. There are extra towels stored here. This bathroom has storage units that block the shower and toilet. LPA advised administrator to remove the storage units to make access easier for the clients. Also the hallway leading to the bathrooms is partially blocked by storage units. LPA advised administrator to remove the storage units to make access easier for the clients. Bedroom #4: Reserved for Administrator. Is made inaccessible to the clients. Access point is through living room. There is an outdoor backyard. There is a disconnected garage used as storage space, made inaccessible to clients. There is another washer unit made inaccessible. There are some exercise equipment for the clients in the back yard. There are 4 sheds in the backyard for storage. Emergency, Disaster Plan, and Staff Training: LPA reviewed facility Emergency and Disaster Plan. LPA reviewed the disaster drills for the facility. LPA reviewed staff training logs. LPA requested and received a copy of the staff and client roster. LPA informed Administrator to develop and implement complaint procedures for the clients. Administrator will email LPA a copy of the board of directors meeting minuets. LPA will return to conduct staff and clients files/records reviews and to conduct interviews. Administrator is asking to extend facility age range to 22, and to transfer administrator. LPA will follow up with Administrator on next steps for these changes. Exit interview complete, a copy of this report was given to the administrator.


facility_name: TJ CARE HOME INC

summary: Facility Evaluation

raw_content:
Narrative:
On this date, Licensing Program Analyst (LPA) Kellie McKinley and Tina Thorn met with Administrator Satnam Singh and Jashandeep Kauri the owners and administrator at 10: AM for a scheduled Component 2 meeting for the Application of TJ Care Homes Inc. The meeting was held in the CCLD Office located at Goethe Rd., Sacramento, CA. The LPA's discussed revisions needed to the A and B documents. The applicants agreed to provide the revisions to the application to the Department within 30 days. If the applicants need more time, they can request for it. A Program Statement was reviewed in person with the applicant. A signed copy of this LIC- 809 was provided to the applicants.

met_with: Satnam Singh and Jashandeep Kaur- Administrator/owners


facility_name: TLC CHILD AND FAMILY SERVICES-COAST HOUSE

summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA) Brian Bertoli completed a Post-licensing inspection for a Group Home and met with the Administrator, Brittany Burns, and Facility Manager, Kayla Martinez. The physical inspection was completed at 10:30am. The entire home was toured, inside and out. The home currently has 5 clients: four minors and one non-minor dependent (NMD) The home has one floor with outside entry via front and side doorways, and is clean, safe, and well-maintained. Carbon monoxide and fire detectors are located throughout the facility. The home consists of 10 bedrooms, 4 bathrooms, kitchen, laundry room, game room, dining room, office and staff bathroom, and living room. All bedrooms are in good repair with adequate storage. The facility is aware that water temperature must be maintained within the regulated range 105-120F. There is an ample supply of perishable and non-perishable food. The facility is located on a campus that has administrative offices, school, and another licensed facility. No deficiencies were cited on this visit. LPA Bertoli completed Care Tools sections for Physical Plant and Operations and interviewed four staff and three youth that were present. Additional sections will be completed at a later date. An exit interview was conducted and a copy of this report was provided to Brittany Burns..

met_with: Brittany Burns and Kayla Martinez


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA) Brian Bertoli conducted an unannounced inspection for the purposes of continuing a Post-Licensing Inspection and met with Administrator Brittany Burns and Facility Manager Kayla Martinez, who assisted with records. A pre-screening call was done with Administrator Burns prior to arrival, and there were no changes since last visit. The records were reviewed at the administrative office, which is on the same campus as the facility. Five client records were reviewed - four minors and one Non-minor Dependent. Technical Advisories were issued for Title Section 84068.2(b)(5) and ILS Section 84470(b)(2)(F), and a deficiency was cited for Title Section 84070(c)(2). Staff records will be reviewed at a later date. Appeal Rights were discussed, and an exit interview was conducted with Kayla Martinez and a copy of the report was left at the facility.


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA) Brian Bertoli conducted an unannounced inspection for the purposes of continuing a Post-Licensing Inspection and met with Administrator Brittany Burns and HR Manager Amanda Atkinson, who assisted with records. A pre-screening call was done with Administrator Burns prior to arrival, and there were no changes since last visit. The records were reviewed at the administrative office, which is on the same campus as the facility. Five staff records were reviewed and found to be acceptable. All staff have the required Criminal Background Clearance. This concludes the Post-Licensing inspection. LPA Bertoli has determined that the facility is operating within the Title 22 regulations for a Group Home. An exit interview was conducted with Amanda Atkinson and a copy of the report was left at the facility.

met_with: Brittany Burns and Amanda Atkinson


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA) Brian Bertoli met with Administrator Brittany Burns and Facility Manager Kayla Martinez. The purpose of the meeting was to investigate two self-reported incidents of client C1 (see LIC 811 dated 9/13/22) breaking into the office and consuming medication and a second incident of client C2 found in bathroom with a rope around their neck. During the visit, LPA Bertoli inspected the facility, interviewed 2 staff, and gathered and reviewed records. No citations were issued at this time. LPA Bertoli will continue to review the incidents at a later date. An exit interview was conducted and a copy of this report was left with the facility.


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA) David Hiett met with Administrator Brittany Burns. The purpose of the visit was to follow-up on an incident the previous night (10/24) in which a client set fire to their room (see attached LIC812 for the Incident Report). All authorized representatives have been notified of the situation. The current census for Coast House is 7 clients, consisting of 4 who identify as male, 2 who identify as female and 1as non-binary. The current census for Orchard House is 4 clients, consisting for 2 identifying as male, 1 identifying as female and 1 as a trans gay male. During the visit, LPA Hiett inspected the building to assess damage and observed that one bedroom sustained major damage in the closet due to fire and other damage incurred as part of the fire fighting efforts. Due to the sprinkler system activating, there was water damage to the floors, baseboards and walls throughout the facility. The smell of smoke is pervasive. The facility is awaiting a report from the responding fire department to be delivered to the Sonoma County Building Inspector to make further determinations. Per approval from Licensing Program Manager Isabel Mendoza, for tonight, 10/25/22, the current 7 residents will be staying at the adjacent facility, Orchard House. Shared rooms will only be occupied by clients from the same program. 2 overnight staff will monitor each hall to prevent the mingling of clients and to perform bed checks every 15 minutes. Further housing plans are pending. No deficiencies were cited at this visit. A copy of the report was shared with the facility. Chief Program Officer Liz Jimenez signed on behalf of the facility.

met_with: Brittany Burns


summary: Facility Evaluation

raw_content:
Narrative:
At 10:00am on 05/17/2023, Licensing Program Analyst (LPA) Karmen Balhotra made an unannounced Annual/Required inspection to the facility listed above. LPA met with Brittany Burns, Director of Residential Treatment, who helped facilitate the inspection. LPA conducted a Guardian check on 05/17/2023 and all employees have a clearance to work at the facility. There are no pool and or bodies of water on the property of the facility. There are no firearms at the facility. The facility has an active accreditation by the Joint Commission from May 14, 2022 and is active for 36 months. All appropriate signage is placed throughout the facility. LPA toured the facility, and the facility has a layout of; staff office, 10 bedrooms and 5 bathrooms, a laundry room, a kitchen, pantry, living room, dining room and family room where clients can have their free space. In addition to the facility, the property consists of another building which is their STRTP location, a school that is clients in placement attend, and administrative offices. Clients' placement providers are their local school district who need educational and or behavioral support. There are currently nine clients in placement at the facility. LPA was able to interview two clients and two staff members regarding the facilities operations. All sharps, cleaning supplies are locked in a cabinet in the laundry room and access for clients are granted if a staff member is present with them. All medications and appropriate documents are in the staff room and are securely locked. The licensee is being cited for 80088(e)(1) Fixture, Furniture, Equipment and Supplies as a Type A violation. A plan of correction was created with Director and will be fixed by the due date of 05/18/2023. At this time, the LPA will recommend licensure to the facility and the provisional license will dissolve. An exit interview was conducted, and a copy of this report was left with Director.

met_with: Brittney Burns


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA) Brian Bertoli made an unannounced Annual/Required inspection to the facility. LPA met with Brittany Burns, Director of Residential Treatment, and Kayla Taylor, who helped facilitate the inspection. Chief Program Officer Liz Jimenez also assisted with the record review. LPA toured the facility, which has two residential buildings, including office, bedrooms, bathrooms, a laundry room, a kitchen, pantry, living room, dining room and family room where clients can have their free space. There are no pools or bodies of water on the premises. There are no firearms at the facility. Cleaning supplies are locked in a cabinet in the laundry room and access for clients are granted if a staff member is present with them. All medications and appropriate documents are in the staff room and are securely locked. In addition to the Group Home, the property has another building which is their Administrative Office and FFA and Adoptions location, and also school that clients attend. Clients' placement providers are though the school districts who need educational and or behavioral support. LPA interviewed three clients and three staff members regarding the facilities operations. No deficiencies were cited. An exit interview was conducted, and a copy of this report was left with Facility.

met_with: Brittany Burns, Kayla Taylor, and Liz Jimenez


summary: Facility Evaluation

raw_content:
Narrative:
On the above date Licensing Program Analyst (LPA) Brian Bertoli conducted an unannounced inspection at the facility and met with Administrator Brittany Burns regarding a Special Incident Report (SIR) that was submitted to Community Care Licensing. The incident took place on 04/15/2025 and the SIR was written to report an incident regarding youth overdosing on medication. LPA Bertoli discussed the incident with Administrator Burns. In the course of reviewing the incident, the Administrator stated that the youth was on a home visit and when the mother dropped her off at the facility, she let the youth take all of the medication with her, leading to the youth being able to ingest it (see LIC 812 dated 4/21/25). LPA issued an Advisory Note of California Code of Regulations, Title Division Six, regulation Health Related Services ... (k)(1) Medication shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication. An exit interview was conducted and a copy of the report and appeal rights were provided to the facility.


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA) Brian Bertoli made an unannounced Annual/Random inspection to the facility. LPA met with Kayla Taylor, Facility Manager, who helped facilitate the inspection. LPA toured the facility, which has two residential buildings, including office, bedrooms, bathrooms, a laundry room, a kitchen, pantry, living room, dining room and family room. There are no pools or bodies of water on the premises. There are no firearms at the facility. Cleaning supplies are locked in a cabinet in the laundry room and access for clients are granted if a staff member is present with them. All medications and appropriate documents are in the staff room and are securely locked. In addition to the Group Home, the campus has other buildings nearby, including their Administrative Office with includes their FFA and Adoptions location, and also a school on the campus that some clients attend. LPA reviewed 5 staff files and conducted confidential interviews. The remaining portions of the Annual Inspection will be completed at a later date. No deficiencies were cited. An exit interview was conducted, and a copy of this report was left with Facility.

met_with: Kayla Taylor


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA) Brian Bertoli made an unannounced visit to the facility and met with Brittany Burns. The purpose of the visit was to conduct a Case Management visit to amend a report. LPA reviewed the amended report with Brittany Burns. An exit interview was conducted. No deficiencies were cited for this visit and a copy of the report was left with the facility.

met_with: Brittany Burns and Kayla Taylor


facility_name: TOOR GROUP HOME

raw_content:
Narrative:
because LPA Carmona attempted and was unable to build rapport, qualify, and interview two of the three clients in care on 6/28/22 due to them being non-verbal. Two individuals have disclosed in their interviews that they have witnessed the minor pulling down their pants only to pee on the grass or while complaining of a smell or pain under their pants. Although the incidents did occur it was not due to lack of supervision but due to client's behaviors. The staff was able to redirect client and other clients in care when the incidents occurred. In addition, interviews conducted on 05/25/22, 06/28/22 and 07/07/22 were inconsistent and there were no witnesses who could testify in regard to staff behaviors. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegations are Unsubstantiated. An exit interview was conducted. A copy of this report and the Appeal Rights were discussed and provided via e-mail to the Administrator.

Investigation Findings:
13On 08/16/22 at 11:05 a.m. Licensing Program Analyst (LPA) Jacqueline Carmona conducted a complaint inspection to the above Group Home (GH) and met with Pushpinder Toor, Administrator for the purpose of delivering findings. During the investigation, LPA Carmona reviewed the agency's file at the licensing office, including the complaint history, criminal background check, incident reports and facility personnel report summary. LPA also reviewed the children's individualized personalized plan, the group home quarterly reports, children's face sheets, children's behavior support plan, medication logs, and the administrator training certificates. LPA Carmona conducted 8 confidential interviews between 05/25/22-07/14/22, an inspection of the facility was made inside and out, and no citations were issued. Based on interviews conducted during the investigation process the allegations cannot be substantiated UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Rosa Rodriguez LICENSING EVALUATOR NAME: Jacqueline Carmona LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, NATOMAS PARK DR., STE FACILITY NAME: TOOR GROUP HOMEFACILITY NUMBER: VISIT DATE: 08/16/2022

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

met_with: Pushpinder Toor, Administrator


summary: Complaint Investigation - Unsubstantiated

raw_content:
Narrative:
Based on confidential interviews conducted during the investigation process it was confirmed the allegation above did occur. 5 confidential interviews confirmed that. clients were left outside in front of the facility without supervision for less than 3 minutes while waiting for the school transportation vehicle to take them to school. In addition, the staff member would remain inside the facility with the screen door closed while clients waited outside. Although there was a staff member present inside the facility, direct supervision was not provided to clients in care while they waited outside the facility. Based on LPA's observations and interviews which were conducted and record review, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. Tittle Regulations, Division 6, Chapter 5 are being cited on the attached LIC9099D. Exit interview conducted, copy of this report and the Appeal Rights were provided to the Pushpinder Toor, Administrator . Based on interviews conducted the allegations above cannot be substantiated because there were inconsistent statements throughout the investigation process. 8 confidential interviews confirmed clients are provided with an adequate amount of clothing. On 1/24/ LPA Carmona observed an adequate amount of clothing for all clients in care and reviewed the clients clothing inventory logs. Lastly, 7 confidential interviews corroborated that the staff do not yell at the clients in care; however, LPA Carmona was unable to interview 2 clients and qualify 1 client in care during the investigation process. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegations are Unsubstantiated. Exit interview conducted, copy of this report and the Appeal Rights were provided to Pushpinder Toor, Administrator.

Investigation Findings:
13On 3/14/ Licensing Program Analysts (LPA) Jacqueline Carmona and Tatyana Shulz conducted a complaint inspection to the above Group Home (GH) and met with Pushpinder Toor, Administrator for the purpose of delivering findings. During the investigation, LPA Carmona reviewed the agency's file at the licensing office, including the complaint history, criminal background check, incident reports, and facility personnel report summary. The minors clothing inventory, most recent IPP's, LIC500, LIC9020, Staff training logs, and Program Statement Section 3. LPA Carmona conducted 14 confidential interviews and attempted 2 confidential interviews from 1/16/24-3/07/24. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Rosa Rodriguez LICENSING EVALUATOR NAME: Jacqueline Carmona LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: TOOR GROUP HOMEFACILITY NUMBER: VISIT DATE: 03/14/2024


raw_content:
Narrative:
Based on evidence obtained and confidential interviews conducted during the investigation process the allegation above cannot be substantiated due to lack of evidence. 4 out of 5 confidential interviews state that due to the client's sensitive skin they suffer from rashes and nodules that will appear on different parts of their body. Due to the rupture of previous nodules in the armpit area, LPA observed the skin around the wound to be darker in color. LPA received hospital documentation highlighting the client's current skin condition and areas of concern. The client also has a history of self injurious behaviors (SIBs) which has lead to previous bruises on their person. Lastly, due to the client being nonverbal and the reporting party not being available for interview after 3 attempts, LPA was unable to gather any further details on the allegation. Although the allegation may have happened or may be valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. Exit interview conducted, copy of this report and the Appeal Rights were discussed and provided to the licensee.

Investigation Findings:
13On September 11, 2025, at 1:55pm Licensing Program Analyst (LPA) Tatyana Shulz made an unannounced visit to deliver findings to the above Group Home (GH) and met with Pushpinder Toor, Administrator. Prior to the meeting LPA Shulz, conducted the 10-day inspection of the facility on 6/11/2025. No deficiencies were cited during that inspection. LPA Shulz requested, Current Staff and Client Roster, Doctor visits and medication list, Staff Schedule for May and June, Staff Contact Information, Client Face Sheets, Needs and Services plans for all clients in care, Individualized Behavior Support Plan (IBSP) for all clients in care and contact information for all involved parties. LPA Shulz conducted 5 interviews and attempted 3 interviews between 6/11/2025-9/08/2025. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Connie Goldie LICENSING EVALUATOR NAME: Tatyana Shulz LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: TOOR GROUP HOMEFACILITY NUMBER: VISIT DATE: 09/11/2025


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analysts Dawn Eunice (LPA) and Yuvi Diaz (LPA) conducted the unannounced annual facility inspection. Upon arrival, there was no one at the home. LPA Eunice called the telephone number of record and spoke to Ms. Toor; she arrived to the facility about 1/2 hour afterwards. LPAs requested a staff and child roster. LPAs observed the menu, personal rights, exit signs, emergency disaster plan, and the license was posted. LPAs toured the facility inside and out. LPAs observed children's bedroom, living room, kitchen, food supply, bathrooms, back and front yards. The water temperature, smoke alarms, and fire extinguishers were checked as well. LPAs did not observe any buildings and grounds deficiencies. A review of Licensing Information System on November 3, 2021, indicates that all facility staff associated had DOJ, FBI, and child abuse index check clearances. LPAs will return to the facility at a later date to complete this annual inspection to include staff and client interviews as well as finish children file review. The facility was found to be clean, safe, sanitary and in good repair. There are not deficiencies cited this date.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analysts Dawn Eunice and Yuvi Diaz (LPAs) conducted an Annual Continuation Inspection on 11-9-2021. The original inspection occurred on 11-05-2021. At today's inspection there were 2 children present and 2 staff. During this time, a county social worker met with her client. At today's inspection LPAs reviewed board meeting minutes, staff and client rosters as well as the children's Independent Personal Plan's. LPAs conducted staff interviews and client interviews. This facility serves developmentally delayed children; one child was partially verbal, one child was non verbal. LPAs reviewed the CARES tool to re-visit information that may have been missed on 11-5-2021. This facility was found to be in substantial compliance with all mandates; it is clean, safe sanitary and in good repair. LPAs conducted exit interview, no deficiencies or advisory notes were given this date.


summary: Facility Evaluation

raw_content:
Narrative:
This report is created because LPA did not save the CARES tool during the 11-9-2021 continued annual inspection.


summary: Facility Evaluation

raw_content:
Narrative:
On 11/28/ Licensing Program Analyst (LPA) Jacqueline Carmona arrived to the above facility with the purpose of conducting an unannounced annual required inspection. LPA Carmona met with Licensee (L) Pushpinder Toor and explained the reason for the visit. LPA Carmona asked (L) for the census and it was 2. The clients are both male from 15 - 18 years of age and are ambulatory. The Licensee was in the facility at the time of the inspection and both clients were in school. LPA Carmona conducted a walk through of the interior and exterior of the facility with (L). The facility is a one story home that consists of a living room, dinning area, kitchen, 2 full bathrooms, bedroom 1, bedroom 2, bedroom 3, bedroom 4, and a garage. Bedroom 1 has a full bathroom, a bed and 2 dressers. Bedroom 2 and bedroom 3 have one bed in each room and two dressers. LPA observed all clients provided adequate amounts of clothing and size of clothing. Bedroom 4 is used as the Licensees office where staff files and client files are stored. The kitchen has a pantry and a refrigerator which were fully stocked with two days of perishable food and seven day's worth of non-perishable food. All clients have a medication log and LPA observed all the medications locked and stored away in cabinet. All four bedrooms, living room, and dining room had furniture in good repair. The garage has a working washer and dryer. The bathrooms are clean, sanitary and functioning with warm water temperature of 110 degrees. The front and back yard are clear and free of debris. LPA checked all fire alarms and carbon monoxide alarms and they are fully functioning. The first aid kit was fully stocked, and readily available. The fire extinguishers were fully charged. There is adequate lighting throughout the home. LPA Carmona reviewed the client roster and LIC 500. LPA Carmona also reviewed staff files and all files had required documents, including CPR/ First Aid certificates, criminal record clearance, and training documents. LPA Carmona reviewed client files and all files had required documents. Clients are accorded dignity in personal relationships with staff and others. Continue to page Clients live in a safe, healthy, comfortable home and are treated with respect. Overall, the home was observed to be clean, safe, sanitary and in good repair. Clients attend school, extracurricular activities, cultural, and personal enrichment activities. The facility is up to date with their fees. Exit interview was conducted. No deficiencies cited during this inspection. A copy of this report will be emailed to the Licensee.

met_with: Pushpinder Toor, Licensee


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analysts (LPAs) Misty Valencia and Tine Thorn on 03/09/2023 at 9: AM. This case management inspection is conducted pursuant to Health and Safety Code Section 1538.9 (a)(2). During the inspection, LPAs Valencia and Thorn met with Pushpinder Toor, Administrator and inspected the facility inside and out. LPA reviewed three (3) clients records and three (3) staff personnel files on site at the facility. LPA reviewed three (3) clients psychotropic medications and medication records. LPA interviewed three (3) staff on site to discuss the facilities policies and procedures of operation. LPA interviewed three (3) clients currently prescribed psychotropic medication. LPA provided a copy of this licensing report to Pushpinder Toor, Administrator No deficiencies are being cited at this time. LPA conducted exit interview with Pushpinder Toor, Administrator


facility_name: TREETOPS CHILDREN'S HOME

summary: Facility Evaluation

raw_content:
Narrative:
On 1/31/2022 at 1: PM LPA Alyssa Ng made an unannounced inspection to conduct an annual required inspection. LPA met with Licensee Erika Juarez. The facility has a census of zero clients. The facility is clean, safe and sanitary and in good repair. All passageways are unobstructed. There are no pools or bodies of water. All disinfectants, cleaning solutions and poisons are located in a locked storage and are not accessible to the residents. Per Licensee Juarez there are no firearms in the facility. The inspected bedrooms were furnished accordingly. There are two bedrooms for clients and one staff room. The kitchen is clean and sanitary.The facility has sufficient two day perishable and seven day nonperishable food supply. The facility has Personal Rights and Emergency Disaster Plans are posted and in clear view. LPA Ng advised Licensee Juarez to get a lockbox for medication that may need to be refrigerated and locks for the pantry and fridge. The facility has not been vendorized and Licensee Juarez informed LPA Ng that Regional Center just accepted her program and will be conducting an inspection on February 15th 2022. No deficiencies were observed today. A copy of this report was left with Licensee Erika Juarez.

met_with: Erika Juarez


summary: Facility Evaluation

raw_content:
Narrative:
On 9/16/22 at 10: AM, Licensing Program Analyst (LPA) Alyssa Ng made a visit to the facility for a post-licensing inspection. LPA met with Administrator Erika Juarez and was informed of the purpose of the visit. Safety precautions were taken, including pre-visit screening, mask-wearing, and hand hygiene. At 11: PM, LPA Ng toured the facility inside and out. The home is single storied, and has two double occupancy bedroom and one staff bedroom. All client bedrooms were equipped with comfortable furnishings which included ample storage space for clients' belongings, desks and chairs, and twin sized beds. The twin beds have drawers underneath for addition storage. Each bedroom has a closet for extra storage space. Client bathroom was clean and furnished with hygiene supplies for each client. The water temperature measured 115 degrees F.The thermostat measured 70 degrees. The facility is clean, safe and sanitary. The kitchen was observed to be clean and free of hazards or chemicals. Sharps were located in a locked cabinet. The weekly menu was in the kitchen. LPA observed at least 2 days of perishable foods and 7 days of nonperishable foods. The smoke detectors are in working order. No bodies of water on the premises. All walkways were free from debris or hazards. Resident and staff files were inspected and observed to be complete. Facility has license, grievance procedures, LIC 610C, personal rights, and foster youth bill of rights posted. The CARE tool found no deficiencies. There are no citations. An exit interview was conducted and a copy of this report was provided to Administrator Erika Juarez, whose signature on this form confirms receipt.


summary: Facility Evaluation

raw_content:
Narrative:
On Tuesday January 17, 2023 at 1: PM Licensing Program Analyst (LPA) Alyssa Ng made an unannounced inspection to conduct an annual required inspection. LPA met with Erika Juarez, Administrator. The facility has a current census of 1 client. The facility is clean, safe and sanitary and in good repair. All passageways are unobstructed. There are 3 rooms and 2 bathrooms. Two of the bedrooms are double occupancy for clients and the other room is for staff. The garage is inaccessible to clients. There are no pools or bodies of water. All disinfectants, cleaning solutions and poisons are located in a locked closet and are not accessible to the residents. There are no firearms in the facility and all sharps are inaccessible to clients in care. The inspected bedrooms were furnished accordingly. The kitchen is clean and sanitary. The facility has sufficient two day perishable and seven day nonperishable food supply. Medications, client and staff binders are located in a locked cabinet. Thermostat and water temperature was 70 degrees F and 115 degrees F. Medication binder was inspected and complete. The facility has Personal Rights and Emergency Disaster Plans are posted and in clear view. LPA Ng reviewed one client file. A review of Guardian Background Check System printed on January 17, 2023 indicated that all facility staff have DOJ, FBI and child abuse index check clearances (CAIC). All client staff files and other documents were reviewed and were observed to be complete. LPA was not able to interview staff or client due to technical issues. LPA will come back at a later time to complete the inspection. No deficiencies were cited today. A copy of this report was given to Erika Juarez, Administrator.


summary: Facility Evaluation

raw_content:
Narrative:
On 1/25/23 at 1: PM, Licensing Program Analyst (LPA) Alyssa Ng made an unannounced inspection to finish the annual required inspection. LPA met with Erika Juarez, Administrator. All staff files and other documents are in a centralized binder. Staff training hours meet the minimum requirements, A review of Guardian Background Check System indicate that all facility staff have DOJ, FBI and child abuse index check clearances (CAIC). LPA Ng interviewed 2 staff. No deficiencies were cited and a copy of this report has been left with the Erika Juarez, Administrator.


summary: Facility Evaluation

raw_content:
Narrative:
On 1/5/24, Licensing Program Analyst (LPA) Mariah Hawkins made a visit to the facility for a required annual inspection. LPA met with Facility Manager Maria Juarez and informed of the purpose of the visit. During the inspection, LPA conducted a tour of the physical plant, inside and outside, interviews, and a review of facility records, including 5 personnel records and 2 resident records. Using the CARE Inspection Tool, no deficiencies were found. LPA observed the facility records to be complete and to be well-organized. The facility is clean, and no hazards were observed. The outdoor activity space is well-maintained, chemicals and medications are locked away, separate linens are provided to each resident, and the bathroom and kitchen spaces are maintained in sanitary condition. The kitchen is fully stocked with food within date. There are no citations. An exit interview was conducted, and a copy of this report was provided to Facility Manager Maria Juarez, whose signature on this form confirms receipt.

met_with: Facility Manager Maria Juarez


summary: Facility Evaluation

raw_content:
Narrative:
On 1/12/24, Licensing Program Analyst (LPA) Mariah Hawkins conducted a case management visit at the facility. LPA met with Facility Manager Maria Juarez and informed of the purpose of the visit. LPA visited to interview a resident. Staff informed LPA that the resident left for a home visit the night prior. LPA conducted an exit interview, and provided a copy of this report to Facility Manager Maria Juarez, whose signature on this report confirms receipt.


summary: Facility Evaluation

raw_content:
Narrative:
On March 18, 2025, at approximately 10: AM, Licensing Program Analyst (LPA) Jonathan Medina conducted an unannounced annual required inspection. LPA met with Facility Manager Maria Juarez and explained the purpose of the visit. The facility currently has one client in care. At approximately 10: AM, LPA Medina initiated the physical plant portion of the CARE Inspection Tool. The facility was observed to be clean, safe, sanitary, and in good repair. All passageways were unobstructed. The facility consists of three bedrooms and two bathrooms. Two of the bedrooms are designated for client use with double occupancy, while the third bedroom is assigned to staff. There were no pools or bodies of water on the premises. All disinfectants, cleaning solutions, and poisons were stored in a locked closet, making them inaccessible to residents. No firearms were present in the facility, and all sharp objects were secured and inaccessible to clients in care. The bedrooms were appropriately furnished, and the kitchen was clean and sanitary. The facility maintained a sufficient food supply, including a two-day supply of perishable food and a seven-day supply of non-perishable food. Medications, along with client and staff binders, were stored in a locked cabinet in the kitchen. At approximately 10: AM, LPA Medina checked the facility's thermostat and water temperature. The home was maintained at 70°F, and the water temperature was measured at 115°F. At approximately 10: AM, LPA observed the facility's first aid kit and confirmed it was complete. Continues on LIC 809-C. At approximately 11: AM, LPA Medina proceeded to review the staffing section of the CARE Inspection Tool. A total of five staff files were reviewed, and all were complete and in compliance with regulatory requirements. At approximately 12: PM, LPA reviewed the client's file, which was also found to be complete and in good order. At approximately 12: PM, LPA reviewed the facility's operations binder, which was complete and up to date. At approximately 1: PM, LPA Medina reviewed the facility's disaster preparedness and emergency intervention plan. It was confirmed that emergency drills are conducted quarterly and that all procedures are current and in compliance with regulations. At approximately 1: PM, LPA verified that the facility meets the standards for serving clients with special health care needs. The facility utilizes Thrive Behavioral Care to ensure compliance with regulations, conduct routine checks, and develop individualized goals for the client. At approximately 1: PM, LPA conducted a confidential interview with the facility manager. Due to the client being non-verbal, an interview could not be conducted. No deficiencies were observed during the inspection. An exit interview was conducted with Facility Manager Maria Juarez. A copy of this report was provided to Ms. Juarez, whose signature on this document confirms receipt.

met_with: Maria Juarez - Facility Manager


summary: Facility Evaluation

raw_content:
Narrative:
On 01/15/2026 at 10:20 a.m., Licensing Program Analyst (LPA) Brenda Rodriguez conducted an unannounced Annual Inspection and met with Maria Juarez, Facility Manager. LPA Rodriguez disclosed the purpose of the inspection and was granted entry into the facility by the Facility Manager. LPA Rodriguez used the CARE Inspection Tool. The facility currently has a census of two clients. LPA Rodriguez reviewed five (5) staff files and two (2) client files. LPA Rodriguez also reviewed the emergency disaster plan binder. LPA Rodriguez conducted one (1) confidential staff interview. During physical plant inspection, no deficiencies were found. LPA Rodriguez toured the facility inside and out. All client bedrooms were equipped with comfortable furnishings which included ample storage space for clients' belongings and full-sized beds. Each bedroom has drawers for extra storage space. Client bathroom was clean and furnished with hygiene supplies for each client. The facility is clean, safe and sanitary. The kitchen was observed to be clean and free of hazards or chemicals. No bodies of water on the premises. All walkways were free from debris or hazards. LPA toured the backyard and observed it to be free from hazards. The required Annual Inspection is complete. No deficiencies were cited. An exit interview was conducted at 1:20 p.m., and a copy of this report was given to Facility Manager Maria Juarez, whose signature on this form confirms receipt.

met_with: Maria Juarez, Facility Manager


facility_name: TRICIA'S HOME

summary: Facility Evaluation

raw_content:
Narrative:
On December 14, 2021 at 9:30 am Licensing Program Analysts (LPA) Isabel Mendoza and Cheyenne McCambridge made an unannounced annual/required visit. LPA met with Administrator, Rochelle Rivera. The facility currently has 4 clients in care. All clients were at school during todays inspection. At 9: AM LPA's did a walk thru the facility was clean, safe, sanitary, and in good repair. The facility consists of four bedrooms, three for clients and one staff bedroom. LPA's observed the facilities fireplace was not properly fenced. Bedroom #3 possibly has a leak issue because the right side of the bedroom's ceiling was wet and there was a small area that was lifted and appeared to have water/air inside. During inspection, the Administrator contacted their repair person and he will be coming out today. The Administrator will contact LPA Mendoza and give LPA an update on the roof/ceiling issue. All bedrooms were inspected and furnished accordingly along with two bathrooms.The kitchen is clean and sanitary. LPA Mendoza inspected the freezer and found several raw food items that were not properly sealed. LPA Mendoza requested the Administrator to throw them out. The facility has sufficient two day perishable and seven day nonperishable food supply. Medications are located in locked cabinet in the garage, currently no clients are on medications. All passageways are unobstructed. There is an outdoor space for the clients, and no hazards or broken items. There are no pools or bodies of water. All disinfectants, cleaning solutions and poisons are located in garage and are not accessible to the residents. At 10: AM LPA's reviewed all four client files, and files were complete. All clients are all over the age of 18, and the facility is currently working with Golden Gate Regional Center (GGRC) and will be converting to an Adult facility once they get okay from GGRC and will follow-up submit all items to CCL. The facility submitted there application to GGRC and CCL about 2 years ago and have been in contact with numerous people at GGRC and currently working with Kevin Abad, LPA Mendoza will reach out to Abad to get an update on the facilities adult application. LPA reminded the facility to follow up with CCL on the adult application as well. LPA will also reach out to Adult Program to confirm receipt of application submitted. The Administrator agreed and will contact LPA with an update by end of next week. LPA Mendoza is requesting the facility to submit age exceptions for all 4 clients in care. The facility will submit support letters from each authorized representative and a letter from the facility no later than Wednesday, 12/21/21. At 11: AM LPA's received all four staff files. All files were reviewed and had all required training and documents. LPA's interviewed the Administrator. During inspection, LPA obtained copy of Rochelle Rivera's updated Administrator certificate. LPA requested the facility to submit the following items no later than Friday 12/17/21, an updated LIC 500 (staff schedule) and LIC 610 (Emergency Disaster Plan). Exit interview conducted. No deficiencies cited during todays inspection. The facility received three Advisory Notes- Technical violations and a copy of the report was left with the facility.

met_with: Administrator Rochelle Rivera


facility_name: TRINITY EL MONTE

summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) T. Davis conducted a virtual Component II session with Trinity Youth Services on September 13, 2022 at 11:00am by way of Microsoft Teams. Present at the Component II from Trinity Youth Services were Gilbert Quinbar, Director of Residential Services; Cher Ofstedahl, CEO; and Jennifer Artiga, Program Director. During the meeting the following items were discussed: 1. Staff Associations 2. Group Home Program Statement revisions 3. Emergency Disaster Plan 4. Emergency Intervention Plan 5. LIC 400 6. Application 7. Neighborhood Complaint Policy 8. Bank Verification Form LPA asked questions regarding the provider's Program Statement to assess their understanding of the regulations in place for a Group Home. LPA advised the provider that all revisions/corrections need to be submitted directly to him for review. The Pre-Licensing inspection will take place on Wednesday, September 14, 2022. LPA discussed the upcoming Pre-Licensing inspection in general and what it involved. LPA advised the provider that their program statement will also be reviewed by his manager, LPM Yan Yeung. Exit Interview conducted


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) T. Davis went to Trinity Youth Services on September 14, 2022 at 11:00am for the purposes of an announced Pre-licensing inspection. The Department has received application materials from the provider to become licensed as a group home licensee at the site. LPA met with Jennifer Artiga, Program Director and Jaime Acosta, Direct Care Supervisor, and together they toured the facility inside and outside. The facility is located in a residential neighborhood and consists of three individual dorms for placement purposes (Luna, Sol, and Estrella). The rooms have twin beds, desk, and closet space. There is also a separate telephone room in each dorm for the clients' use. Sharp knives and cleaning supplies are kept locked in areas inaccessible to children. Overall, the facility appeared clean, safe, and sanitary. LPA observed fully charged fire extinguishers throughout the facility. Exit signs were also visible throughout the facility as well. The outdoor areas were observed to be free of debris and hazards. LPA observed the kitchen area to be clean and the refrigerators were well stocked with ample food supply. LPA also observed adequate perishable and nonperishable food items at the facility. There is no swimming pool or other bodies of water on the premises. The Program Director stated that there weren't any firearms or other weapons on the premises. The facility has locked file cabinets for the client files. Smoke alarms were operable throughout the facility. There is adequate space for indoor and outdoor activities. Medications will be kept locked in the Team Administrator's office. The facility also has nurse staff and clinicians. During the tour of the facility, LPA observed copies of the Emergency Plan, Inspection Report, Disaster Plan Policy and Procedures, Foster Care Ombudsman information, and food and nutrition menus. The facility will provide educational services at the facility for each client. LPA observed two classrooms on the premises. Each classroom has seating capacity for twelve students each. The classrooms were set up in a "classroom style" setting and the environment is situated for classroom learning. LPA met the lead teacher who advised LPA that she's currently working on the curriculum and other educational components as they await their first students. LPA also met the facility's bilingual instructional paraprofessionals. LPA found no Title 22 deficiencies on this date. Exit interview conducted LPA Davis discussed warm weather conditions and precautions with the provider and provided them with the Department's website address (www.ccld.ca.gov). LPA also conducted a Component III at the facility with Jennifer Artiga, Program Director. During the Component III meeting, the following forms were given and/or discussed: LIC Preplacement of Appraisal Information LIC Appraisal/Needs and Services Plan LIC Physician's Report for Community Care Facilities LIC Identification and Emergency Information LIC Personal Rights LIC Record of Client's Safeguarded Cash Resources LIC Consent for Emergency Medical Treatment LIC Centrally Stored Medication and Destruction Record LIC Client/Resident Personal Property and Valuables LIC Unusual Incident/Injury Report LIC Admission Agreement Guide The provider was also briefed about community passes, room searches/strip searches, community sensitivity, and client education.