facility_name: MINDFUL GROWTH FOUNDATION #1

raw_content:
Investigation Findings:
13Staff returned confiscated marijuana to minor. Staff is harassing youth. Staff perform unreasonable searches of minors' belongings. On February 2, 2022 at 1:33pm, Licensing Program Analyst (LPA) Daphne Edison made an unannounced visit to Mindful Growth Foundation #1 and spoke with Sherlyn Johnson, Administrator. The purpose of this visit was to deliver the findings for the above complaint allegations. During the investigation, a total of three (3) clients and five (5) staff were interviewed. Confidential interviews and documentary evidence provided in Special Incident Report #787099 did not substantiate the allegation that staff returned confiscated marijuana to minor. Documentary evidence also reveal client's knowledge and agreement of the house rules as it relates to the policy on marijuana possession and their use on the physical premises of the facility. Confidential interviews conducted did not reveal staff perform unreasonable searches of minors' belongings. Confidential interviews conducted did not reveal staff is harassing youth. LPA obtained signed copies by three (3) clients of the house rules, Code of Ethics, and admissions agreement for the clients in care. LPA also obtained copies of the Special Incident Reports regarding the allegation staff returned confiscated marijuana to minor. Based on the interviews conducted, documentary evidence, the information gathered did not produce corroborating evidence to support the above said allegations. LPA Edison was not able to determine if the above said allegations occurred, therefore the allegations are determined to be unsubstantiated, meaning that although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that a violation occurred. No deficiencies were observed or cited at the time of this investigation. Exit interview was conducted, and a copy of this report will be emailed to the Administrator. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Daphne Edison 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 3

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

met_with: Sherlyn Johnson


state: CA

summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
Based on the interviews conducted, documentary evidence, the information gathered did not produce corroborating evidence to support the above said allegations. LPA Edison was not able to determine if the above said allegations occurred, therefore the allegations are determined to be unsubstantiated, meaning that although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that a violation occurred. Based on the observations made during today's inspection, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. Exit interview was conducted, and a copy of this report will be emailed to the Administrator.

Investigation Findings:
13On March 16, 2022 at 1:00pm, Licensing Program Analyst (LPA) Daphne Edison made an unannounced visit to Mindful Growth Foundation #1 and spoke with Sherlyn Johnson, Administrator. The purpose of this visit was to deliver the findings for the above complaint allegations. During the investigation, a total of four (4) clients, three (3) staff and two (2) witnesses were interviewed. Confidential interviews and documentary evidence provided did not substantiate the allegation of a wrongful eviction. Documentary evidence shows that there were several options provided for placement and housing. Confidential interviews and documentary evidence provided does not substantiate the allegations that minors are being spoken to inappropriately while in care and minor was handled in a rough manner. LPA obtained copies of Special Incident Reports (SIR) #786524 and #796631, staff certification of Crisis Training in De-Escalation for three (3) staff, and Placement Preservation meeting notes. Continued on LIC 9099_C UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Daphne Edison LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290B FACILITY NAME: MINDFUL GROWTH FOUNDATION #1FACILITY NUMBER: VISIT DATE: 03/16/2022

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

report_type: Complaint Investigation

met_with: Sherlyn Johnson-Administrator

complaint_status: unsubstantiated


raw_content:
Narrative:
Although, Client #5 revealed in a confidential interview that Staff #4 spoke inappropriately to Client #5 and handled Client #5 in a rough manner, other confidential interviews and documentary evidence did not substantiate the allegations that minors are being spoken to inappropriately while in care and minor was handled in a rough manner. LPA obtained copies of Special Incident Reports (SIR) #792472, #786524, and #796631, staff certification of Crisis Training in De-Escalation for three (3) staff, and Placement Preservation meeting notes. Based on the interviews conducted, documentary evidence, the information gathered did not produce corroborating evidence to support the above said allegations. LPA Edison was not able to determine if the above said allegations occurred, therefore the allegations are determined to be unsubstantiated, meaning that although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that a violation occurred. Based on the observations made during today's inspection, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. Exit interview was conducted, and a copy of this report will be emailed to the Administrator.

Investigation Findings:
13This an amended report from the original date of 3/16/2022. On March 16, 2022 at 1:00pm, Licensing Program Analyst (LPA) Daphne Edison made an unannounced visit to Mindful Growth Foundation #1 and spoke with Sherlyn Johnson, Administrator. The purpose of this visit was to deliver the findings for the above complaint allegations. During the investigation, a total of five (5) clients, four (4) staff and three (3) witnesses were interviewed. Confidential interviews and documentary evidence provided did not substantiate the allegation of a wrongful eviction. Documentary evidence shows that there were several options provided for placement and housing. Documentary evidence also revealed Client #1 was given a 14-Day notice informing them of their placement termination. Continued on LIC 9099-C UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Daphne Edison LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290B FACILITY NAME: MINDFUL GROWTH FOUNDATION #1FACILITY NUMBER: VISIT DATE: 07/13/2022

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


summary: Facility Evaluation

raw_content:
Narrative:
Fannie Linnear - Facility Manager On December 10, 2021 at 12:49pm, Licensing Program Analyst (LPA) Daphne Edison made an unannounced visit to Mindful Growth Foundation #1 for the purpose of conducting a case management for an incident that occurred on December 6, 2021. LPA discussed Special Incident Report (SIR) #787530 with the Facility Manager which was reported involving a client calling the paramedics for themselves due to the effects of client possibly smoking marijuana or taking mushrooms. LPA interviewed Facility Manager and conducted other confidential interviews on this date regarding the incident. LPA requested the shift notes for the date the incident occurred. Facility manager stated they would have the shift notes emailed to LPA. Based on information gathered there was insufficient information to support the above allegation at this time. Additional interviews will be conducted at a later date. Exit interview was conducted and a copy of the report was emailed for a signature.

report_type: Facility Evaluation

visit_type: Case Management

met_with: Fannie Linnear - Facility Manager


facility_name: MINDFUL GROWTH FOUNDATION #2

raw_content:
Narrative:
Based on the interviews conducted and documentary evidence, the information gathered did not produce corroborating evidence to support the above said allegations. LPA Edison was not able to determine if the above said allegations occurred, therefore the allegations are determined to be unsubstantiated, meaning that although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that a violation occurred. Based on the observations made during today's inspection, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. Exit interview was conducted, and a copy of this report will be emailed to the Administrator.

Investigation Findings:
13On March 16, 2022 at 2:30pm, Licensing Program Analyst (LPA) Daphne Edison made an unannounced visit to Mindful Growth Foundation #2 and spoke with Sherlyn Johnson, Administrator. The purpose of this visit was to deliver the findings for the above complaint allegations. During the investigation, a total of three (3) clients, three (3) staff and three (3) witnesses were interviewed. Confidential interviews and documentary evidence provided did not substantiate the allegation of Facility staff do not provide adequate supervision for the residents in care. Documentary evidence reveal the staff to client ratio. Confidential interviews and documentary evidence do not substantiate the allegation Facility staff engaged in a physical altercation with resident. Continued on LIC 9099-C UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Daphne Edison LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290B FACILITY NAME: MINDFUL GROWTH FOUNDATION #2FACILITY NUMBER: VISIT DATE: 03/16/2022

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


raw_content:
Narrative:
Documentary evidence of SIR #810391 revealed Client #1 (C1) AWOL'd with another peer on 4/29/2022 and incident was cross reported to all agencies including C1's County Social Worker (CSW). Documentary evidence and inconsistent statements also revealed that C1's CSW email may be reported as incorrect in the ITrack system which may be an indicator as to why CSW may not have received the cross reported SIR's. from the facility. Confidential interviews and documentary evidence do not substantiate the allegation that facility does not transport child to school on time. Confidential interviews and documentary evidence provided revealed C1's refusal to attend school on two (2) occasions. LPA obtained two (2) signed copies of client school refusal forms for C1. Confidential interviews and documentary evidence also reveal when C1 does attend school, C1 is transported by staff to school. Documentary evidence also revealed that on one (1) occasion, C1 walked to school. LPA obtained copies of facility shift notes documenting staff transporting C1 to school. Confidential interviews and LPA application revealed that the facility telephone number does have an active voicemail set up. LPA made a telephone call to the facility telephone number and was able to leave a voicemail message. Based on the interviews conducted, documentary evidence, the information gathered did not produce corroborating evidence to support the above said allegations. LPA Edison was not able to determine if the above said allegations occurred, therefore the allegations are determined to be unsubstantiated, meaning that although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that a violation occurred. Based on the observations made during today's inspection, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. Exit interview was conducted, and a copy of this report will be emailed to the Administrator.

Investigation Findings:
13On June 1, 2022 at 10:12am, Licensing Program Analyst (LPA) Daphne Edison made an unannounced visit to Mindful Growth Foundation #2 and spoke with Fannie Linnear, Facility Manager. The purpose of this visit was to deliver the findings for the above complaint allegations. During the investigation, a total of three (3) staff, three (3) clients, and one (1) witness were interviewed. Confidential interviews and documentary evidence provided did not substantiate the allegation facility does not report child AWOL. LPA obtained copies of Special Incident Report's (SIR) #810391, #810240, #807793, 809577, 808498, and #807735 regarding Client #1's (C1) AWOL incidents. Continued on LIC 9099-C UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Daphne Edison LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290B FACILITY NAME: MINDFUL GROWTH FOUNDATION #2FACILITY NUMBER: VISIT DATE: 06/01/2022

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

met_with: Fannie Linnear-Facility Manager


raw_content:
Narrative:
Confidential interviews and documentary evidence revealed inconsistent statements and do not substantiate the allegation Facility staff engaged in a physical altercation with resident. Staff interviews revealed no knowledge of any facility staff engaging in a physical altercation with any resident in care. Confidential interviews revealed inconsistency in statements regarding whether residents removed bedroom window screens for the purpose of going in and out of the facility without staff knowledge and for the purpose of residents smoking marijuana out of the bedroom windows. Confidential interviews and inconsistent statements determined that although it was reported that staff would not address residents smoking marijuana outside of the facility, it could not be determined whether or not staff did not address any resident who was caught smoking marijuana at the facility. Based on the interviews conducted and documentary evidence, the information gathered did not produce corroborating evidence to support the above said allegations. LPA Edison was not able to determine if the above said allegations occurred, therefore the allegations are determined to be unsubstantiated, meaning that although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that a violation occurred. No deficiencies were observed or cited at the time of this investigation. Exit interview was conducted, and a copy of this report will be emailed to the Administrator.

Investigation Findings:
13This an amended report from the original date of 3/16/2022. On March 16, 2022 at 2:30pm, Licensing Program Analyst (LPA) Daphne Edison made an unannounced visit to Mindful Growth Foundation #2 and spoke with Sherlyn Johnson, Administrator. The purpose of this visit was to deliver the findings for the above complaint allegations. During the investigation, a total of five (5) clients, five (5) staff and three (3) witnesses were interviewed. Confidential interviews and documentary evidence provided did not substantiate the allegation of Facility staff do not provide adequate supervision for the residents in care. Interviews with staff and clients revealed that clients are adequately supervised, and an incentive program is in place to encourage clients with positive behavior and following the STRTP program rules. Continued on LIC 9099-C UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Daphne Edison LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290B FACILITY NAME: MINDFUL GROWTH FOUNDATION #2FACILITY NUMBER: VISIT DATE: 07/07/2022

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


raw_content:
Narrative:
Documentary evidence also reveal client's acknowledgement and agreement of the house rules as it relates to the policy on marijuana possession and their use on the physical premises of the facility. LPA obtained signed copies by Client #1 (C1), Client #2 (C2), and Client #3 (C3) of the house rules, Code of Ethics, and admissions agreement. LPA also obtained signed copies of Needs and Services Plans for C1, C2, and C3, as well as signed copies of the incentive plan contract as it relates to the drug policy for the facility. Based on the interviews conducted, documentary evidence, the information gathered did not produce corroborating evidence to support the above said allegations. LPA Edison was not able to determine if the above said allegations occurred, therefore the allegations are determined to be unsubstantiated, meaning that although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that a violation occurred. LPA provided Facility Manager with a current Foster Youth Bill of Rights for the facility. Based on the observations made during today's visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. Exit interview was conducted, and a copy of this report will be emailed to the Administrator.

Investigation Findings:
13On August 25, 2022 at 12:46pm, Licensing Program Analyst (LPA) Daphne Edison made an unannounced visit to Mindful Growth Foundation #2 and spoke with Lonette Flowers, Facility Manager. The purpose of this visit was to deliver the findings for the above complaint allegations. During the investigation, a total of three (3) clients, four (4) staff, and five (5) witnesses were interviewed. Confidential interviews and documentary evidence provided did not substantiate the allegation of Staff are not adequately supervising youth. LPA obtained a copy of the LIC 500 which reflects staff supervision for clients in care and overnight shift notes for the period of 7/25/2022 - 8/5/2022. Confidential interviews and documentary evidence did not substantiate the allegations of Staff are providing marijuana to minors and Minors smoking marijuana. Continued on LIC 9099-C UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Daphne Edison LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290B FACILITY NAME: MINDFUL GROWTH FOUNDATION #2FACILITY NUMBER: VISIT DATE: 08/25/2022

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

met_with: Lonette Flowers-Facility Manager


raw_content:
Narrative:
Documentary evidence revealed client's acknowledgement and agreement of the house rules as it relates to the policy on marijuana possession and their use on the physical premises of the facility. LPA obtained copies of the House Rules and Code of Ethics signed by clients, client Needs and Services Plan, staff shift notes, and client incident reports. LPA also obtained signed copies of the incentive plan contract as it relates to the drug policy for the facility. Based on the interviews conducted, documentary evidence, the information gathered did not produce corroborating evidence to support the above said allegation. LPA Edison was not able to determine if the above said allegation occurred, therefore the allegation is determined to be unsubstantiated, meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that a violation occurred. Based on the observations made during today's inspection, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. Exit interview was conducted, and a copy of this report will be emailed to the Administrator.

Investigation Findings:
13On July 27, 2023 at 12:12pm, Licensing Program Analyst (LPA) Daphne Edison made an unannounced visit to Mindful Growth Foundation #2 and spoke with Thomas Washington, Facility Manager. The purpose of this visit was to deliver the findings for the above complaint allegation. LPA was informed that Sherlyn Johnson, Administrator is not at the facility. During the investigation LPA Edison interviewed and accounted for all available relevant parties and gathered pertinent information regarding the allegation. Based on interviews, documentary evidence, and statements obtained during the investigation process, LPA was unable to corroborate the allegation. Confidential interviews, consistent statements and documentary evidence did not indicate facility staff are allowing minors to smoke marijuana on the premises. Continued on LIC 9099-C UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Daphne Edison LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, N. Continental Blvd. #290B FACILITY NAME: MINDFUL GROWTH FOUNDATION #2FACILITY NUMBER: VISIT DATE: 07/27/2023

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

met_with: Thomas Washington - Facility Manager


raw_content:
Narrative:
Per Interim Licensing Standards (ILS), Article 6, Section 87065.2 (b)(1)-Personnel Duties is being cited. (See LIC9909D). Exit interview was completed and copy of the report and appeal rights were discussed and provided to Facility Administrator, Thomas Washington . Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation did or did not occur, therefore, the allegation is unsubstantiated. No deficiencies cited. Exit interview completed and copy of the report and appeal rights were discussed and provided to Facility Administrator, Thomas Washington.

Investigation Findings:
13On 08/13/25, at 12:13PM, Licensing Program Analyst (LPA) Andrea Aceves and Licensing Program Manager (LPM) Lakescia Smith made an unannounced visit to the above facility to conclude the investigation and to deliver the findings on the above allegation. LPA Andrea and LPM Lakescia met with Facility Administrator, Thomas Washington. During the investigation, LPA Andrea interviewed all available parties and reviewed LIC500-Personnel Report, C1's Needs and Services Plan, pictures of staff sleeping, staff disciplinary reports and signed acknowledgement of policy from S2 and S3. It was reported that "Staff was asleep during his work shift". Interview statements from staff, documentation of disciplinary reports and pictures of staff #2 sleeping were reviewed. In addition, an amended Mindful Growth investigative report that indicates that S2 admitted to being asleep on shift; the preponderance of evidence standard has been met. Per interview with Staff #2, he confirmed that he fell asleep while on shift. Therefore, the allegation of "Staff was asleep during his work shift" is SUBSTANTIATED. See LIC9099C. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Andrea Aceves LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION EL SEGUNDO CRP RO, N. Continental Blvd. #290B FACILITY NAME: MINDFUL GROWTH FOUNDATION #2FACILITY NUMBER: VISIT DATE: 08/13/2025

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

met_with: Facility Administrator Thomas Washington


summary: Facility Evaluation

raw_content:
Narrative:
On March 8, 2022 at 9:06am, Licensing Program Analysts (LPA) Daphne Edison made an unannounced visit to Mindful Growth Foundation #2 for the purpose of conducting an Annual Required Inspection. LPA met with Thomas Washington, Facility Manager who granted access into the home and together a tour was conducted both inside and out. The home is licensed to provide care and supervision for six (6) children, ages 12-17 years, ambulatory only. The facility will also provide services to non-minor dependents pursuant to W & I code 16501.1 (C) (1). The census today is six (6). The home is set up as follows: This is a three (3) bedroom, two (2) bathroom home and is located in a residential neighborhood. The home has a living room, dining area, kitchen, a laundry area, a staff office, and a detached garage. Living Room: Equipped with a rectangle wooden storage desk, a sofa, a mounted TV, and has a decorative fireplace mount. Dining Area: Equipped with a wooden table with six (6) chairs, there is also a small desk and chair for client use. Kitchen: Equipped with a stove/oven with five (5) burners, all working at this time. There is a microwave and a refrigerator/freezer combination. The home was observed to have one (1) week of nonperishable and two (2) days of perishable food supplies. Bedroom #1: Occupied. Equipped with two (2) twin sized beds with adequate storage and closet space. Bedroom # 2: Occupied. Equipped with two (2) twin sized beds with adequate storage and closet space. Continued on LIC 809-C Bedroom#3: Occupied. Equipped with two (2) twin sized beds with adequate storage and closet space. (Bathroom #2 is located inside of Bedroom #3). All bedrooms were observed to have adequate lighting, mattresses in good repair and clean linens and bedding. Bathroom #1: Located in the hallway between Bedroom #2 and #3. Equipped with a bathtub/shower combination, a toilet, and a sink. Clean and in operable condition. Bathroom #2: (Located inside of Bedroom #3). Equipped with a standing shower, a toilet, and a sink. Clean and in operable condition. Laundry Area: Located off the kitchen. Equipped with a washer and dryer. Laundry supplies, cleaning solutions are locked in a cabinet with a key accessible by staff. There is a door leading to the back yard. Staff Office: Located off of the dining area. Equipped with a desk, chair, a computer, and it remains locked when not in use by staff. Detached garage: Located in the back of the home and was observed to be used for storage. LPA observed the home to be clean, safe, sanitary and in good repair. Passageways, stairways, inclines, ramps and open porches are unobstructed. Disinfectants, cleaning solutions, and poisons items are made inaccessible to clients. All knives and sharp objects are made inaccessible to the clients in care. Medications are locked in a toolbox stored in the staff office. There are no security bars on the windows. There are no weapons located in the home. All smoke detectors, carbon monoxide detectors tested audible and are working properly. The home is equipped with two (2) regulation fire extinguishers. During this visit, LPA conducted three (3) client interviews and reviewed three (3) client records which contained copies of 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 reported that children attend school, extracurricular, cultural and personal enrichment activities. Continued on LIC 809-C LPA will review staff records and conduct staff interviews on a later date. 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. Facility vehicle is in good repair with current and valid vehicle registration and insurance. Based on the observations made during today's inspection, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. Exit Interview was conducted, and a copy of this report will be emailed to the Administrator.

visit_type: Annual

met_with: Thomas Washington-Facility Manager


summary: Facility Evaluation

raw_content:
Narrative:
On March 24, 2022 at 9:08am, Licensing Program Analyst (LPA) Daphne Edison made an unannounced visit to Mindful Growth Foundation #2 for the purpose of conducting a Case Management of an Annual Required Inspection which took place on March 8, 2022. LPA met with Thomas Washington, Facility Manager who granted access into the home and together a tour was conducted both inside and out. The home is licensed to provide care and supervision for six (6) children, ages 12-17 years, ambulatory only. The facility will also provide services to non-minor dependents pursuant to W & I code 16501.1 (C) (1). The census on this day is five (5). The home is set up as follows: This is a three (3) bedroom, two (2) bathroom home and is in a residential neighborhood. The home has a living room, dining area, kitchen, a laundry area, a staff office, and a detached garage. LPA observed the home to be clean, safe, sanitary and in good repair. Passageways, stairways, inclines, ramps, and open porches are unobstructed. Disinfectants, cleaning solutions, and poisons items are made inaccessible to clients. All knives and sharp objects are made inaccessible to the clients in care. Medications are locked in a toolbox stored in the staff office. There are no security bars on the windows. There are no weapons located in the home. All smoke detectors, carbon monoxide detectors tested audible and are working properly. The home is equipped with two (2) regulation fire extinguishers. Children in care are always supervised and protected. 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 reported that children attend school, extracurricular, cultural, and personal enrichment activities. Continued on LIC 809-C During this visit, LPA reviewed six (6) staff records and conducted three (3) staff interviews. 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. LPA advised Executive Director and Facility Manager about Licensing Fees of $454.00 due by 4/1/2022. Executive Director stated Licensing Fees will be paid by 4/1/2022. Based on the observations made during today's inspection, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. Exit Interview was conducted, and a copy of this report will be emailed to the Administrator.


summary: Complaint Investigation - Unsubstantiated

raw_content:
Narrative:
During the course of the investigation, LPA received conflicting information regarding the alleged event. While staff and clients denied the allegation LPA did see some photo evidence of trash in the neighbors drive way that was probably thrown from the clients bedroom windows, Based on conflicting testimony and lack of evidence, LPA could not determine whether there was an incident where a client lit paper on fire and threw it out the window, and whether the staff's response was appropriate to the incident. Therefore, based on the available information LPA gathered from interviews, the preponderance of the evidence standard has not been met; therefore, the allegation of "Staff are not properly supervising minors in care resulting in incidents of minors lighting paper on fire" is found to be unsubstantiated. Exit Interview Conducted, a copy of this report was given to the Facility Manager.

Investigation Findings:
13On 3/25/26, Licensing Program Analyst (LPA) Reagan Cohen arrived at the above facility and met with Darryl Shobey Facility Manager for the purpose of delivering complaint findings regarding the above allegation. During the course of the investigation, LPA interviewed involved staff, clients, and witnesses. All clients denied any incident of a client lighting paper on fire and throwing it out the window. All staff also denied any incident involving a client lighting paper on fire and throwing it out the window. The complainant was the only testimony evidence that stated the allegation that a client lit paper on fire and threw it out the window. LPA did receive photo evidence of trash right outside the client's bedroom windows that landed on the neighbor's property. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Reagan Cohen LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION EL SEGUNDO CRP RO, N. Continental Blvd. #290B FACILITY NAME: MINDFUL GROWTH FOUNDATION #2FACILITY NUMBER: VISIT DATE: 03/25/2026

met_with: Darryl Shobey Facility Manager


summary: Complaint Investigation - Substantiated

raw_content:
Narrative:
No staff could recall any incident involving a client trespassing on a neighbor's property while drunk. Witness testimony claimed that multiple times, clients from the facility have come onto a neighbor's property and smoked specifically in the driveway area. Witness testimony also claimed that there was an incident where a client was on a neighbor's property while drunk. LPA observed photo evidence of the client's bedroom window screens being left on the neighbors drive way, presumably after a client AWOLed through the window and left it there. LPA also observed a picture of a homemade bong in the neighbors drive way right below the client's bedroom windows. LPA observed video evidence of a client loitering on the neighbor's front and side porch and even peeing on the front porch, presumably while drunk. During the course of the investigation, LPA received conflicting testimony evidence regarding the allegations. While most clients and staff stated that clients don't smoke on neighbors' property. One client and witness confirmed that there have been a couple of incidents where a client went onto a neighbor's property to smoke. All clients and staff denied an incident where a client was drunk on a neighbor's property. Witness testimony stated that there was an incident where a client was on a neighbor's property while drunk. LPA observed video evidence corroborating the witness claims that a client trespassed and peed on the neighbor's property. LPA observed photo evidence of trash, drug paraphernalia and a window screen on the neighbors drive way, corroborating the claim that clients trespass on/through the neighbor's property and even smoke on their property. Based on testimony and photo/video evidence, LPA concludes that there were incidents where clients smoked, trespassed, and even peed on a neighbor's property. Therefore, based on the available information LPA gathered from interviews, the preponderance of the evidence standard has been met; therefore, the allegation of "Staff are not properly supervising minors in care, resulting in incidents of trespassing" is found to be substantiated. Exit Interview Conducted, a copy of this report was given to the Facility Manager.

Investigation Findings:
13On 3/25/26, Licensing Program Analyst (LPA) Reagan Cohen arrived at the above facility and met with Darryl Shobey Facility Manager for the purpose of delivering complaint findings regarding the above allegation. During the course of the investigation, LPA interviewed involved staff, clients, and witnesses. Most clients denied any trespassing on neighbors' property. All clients denied any incident involving returning to the facility drunk and accidentally going on the neighbor's property. While most clients admitted to smoking from time to time, most clients stated that they smoke on their community passes or walks and not on any private property or near the facility. One client did admit to smoking on a neighbor's property a couple of times, specifically in the neighbors drive way between the facility and the neighbor's house. All staff interviews shared that while some clients do struggle with substance abuse, they don't smoke or trespass on neighbors' property. All staff shared that they have never had any complaints from neighbors about clients on their property smoking or being drunk. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lakescia Smith LICENSING EVALUATOR NAME: Reagan Cohen LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 34-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION EL SEGUNDO CRP RO, N. Continental Blvd. #290B FACILITY NAME: MINDFUL GROWTH FOUNDATION #2FACILITY NUMBER: VISIT DATE: 03/25/2026

complaint_status: SUBSTANTIATED


facility_name: MOLLIE'S HOUSE

raw_content:
Investigation Findings:
13On 07/22/2021, Licensing Program Analysts (LPAs) Lisa Slusher and Tamara Melikian conducted a follow up complaint investigation to inform the facility of the outcome of the investigation. Met at the facility by Executive Director Torella Minor. Interviews were conducted and documents were obtained. Client (#1) had an initial appointment with a mental health clinician, but it is unclear whether a follow up appointment was scheduled and the client (#1) is no longer in placement. Client (#1) was placed at the end of the school year and is no longer in placement, however was advised that client (#1) would be attending school in a home study format. Based on the above, there is not a preponderance of evidence that the clients are not being provided services needed or that the client (#1) was not going to be able to attend school in person for the upcoming school year. A copy of this report is left with the Executive Director. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Lisa Slusher 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 STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORTCALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, E SHAW AVE This is an official report of an unannounced visit/investigation of a complaint received in our office on 06/30/2021 and conducted by Evaluator Lisa Slusher PUBLICCOMPLAINT CONTROL NUMBER: 24-CR- FACILITY NAME:MOLLIE'S HOUSEFACILITY NUMBER: ADMINISTRATOR:MINOR, TORELLAFACILITY TYPE: ADDRESS: WEST BULLARDTELEPHONE: (559) 425- CITY:FRESNOSTATE: CAZIP CODE: CAPACITY:6CENSUS: 3DATE: 07/22/ UNANNOUNCEDTIME BEGAN: 10: AM MET WITH:Torella MinorTIME COMPLETED:12: PM 9Client not able to have telephone calls. INVESTIGATION FINDINGS: 13On 07/22/2021, Licensing Program Analysts (LPAs) Lisa Slusher and Tamara Melikian conducted a follow up complaint investigation to inform the facility of the outcome of the investigation. Met at the facility by Executive Director Torella Minor. Interviews were conducted and documents were obtained. Based on interviews conducted, client (#1) was unable to have telephone calls with family members that were not on an approved contact list. Based on a review of client records, there was not a valid court order (for family contacts) or limitations approved by the authorized representative (for other contacts). Based on the above, the complaint is Substantiated. Deficiency on the attached page. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Lisa Slusher 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: 2 of Control Number 24-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, E SHAW AVE FACILITY NAME: MOLLIE'S HOUSEFACILITY NUMBER: 107202634

met_with: Torella Minor


raw_content:
Investigation Findings:
13Licensing Program Analyst (LPA) Lisa Susher conducted a follow up complaint inspection at the facility and spoke with Facility Manager Renee Lane. The purpose of the inspection was to deliver the findings for the above complaint allegation(s). During the investigation, LPA conducted a record review and conducted interviews with Foster youth, staff and others. LPA conducted review of program statement and incident report dated 7/13/21. Due to the conflicting information revealed in the interview process, the agency has deemed the allegation(s) to be unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of evidence to provide the alleged violation did or did not occur, therefore the allegation is unsubstantiated. An exit interview was conducted, and a copy of this report was provided to the social work supervisor. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Lisa Slusher 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 STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORTCALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, E SHAW AVE This is an official report of an unannounced visit/investigation of a complaint received in our office on 07/15/2021 and conducted by Evaluator Lisa Slusher PUBLICCOMPLAINT CONTROL NUMBER: 24-CR- FACILITY NAME:MOLLIE'S HOUSEFACILITY NUMBER: ADMINISTRATOR:MINOR, TORELLAFACILITY TYPE: ADDRESS: WEST BULLARDTELEPHONE: (559) 425- CITY:FRESNOSTATE: CAZIP CODE: CAPACITY:6CENSUS: DATE: 11/12/ UNANNOUNCEDTIME BEGAN: 09: AM MET WITH:Renee LaneTIME COMPLETED:12: PM 9Facility did not follow removal procedures with C1. INVESTIGATION FINDINGS: 137/27/21, Licensing Program Analyst (LPA) Lisa Slusher conducted a complaint inspection for Mollie's House STRTP and met with Facility Manager Renee Lane. Interviews were conducted of the administrator, staff and others. LPA reviewed files for submitted incident reports for the youth. LPA reviewed discharge information. Information gathered verifies that tthe facility did not follow appropriate procedures to try to mitigate permanent removal from the facility following temporary removal by law enforcement. Citation issued on this date for section 87068.4(c) Removal And transfer. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Lisa Slusher 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: 2 of Control Number 24-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, E SHAW AVE FACILITY NAME: MOLLIE'S HOUSEFACILITY NUMBER: 107202634

met_with: Renee Lane


summary: Complaint Investigation - Substantiated

raw_content:
Investigation Findings:
13On July 11, 2022, Licensing Program Analyst (LPA) Tamara Melikian conducted an complaint inspection to inform the facility of the outcome of the investigation. Met at the agency by Executive Director Torella Minor. Confidential interviews were conducted and records were reviewed. Based on the above, the complaint is Substantiated. Deficiencies on the attached page. A copy of this report is left with the Executive Director. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Tamara Melikian 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 24-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, E SHAW AVE FACILITY NAME: MOLLIE'S HOUSEFACILITY NUMBER: 107202634


summary: Complaint Investigation - Substantiated

raw_content:
Investigation Findings:
13On the above date, LPA (Licensing Program Analyst) Lisa Slusher conducted a complaint inspection for the purpose of resolving the investigation into the above matter. On 8/21/ S1 had an activity with the youth. During the activity, the staff person allowed a game of "truth or dare" where the dares included licking the floor, drinking a spoonfull of water from the toilet tank, drinking milk with mustard mixed in and wiping their hands underneath the couch and licking their fingers. During the course of the investigation, LPA conducted interviews and reviewed documentation. Based on confidential interviews and documentation the allegation is SUBSTANTIATED. On the following page, the facility is cited under the General Licensing Requirements and the STRTP Interim Licensing Standards for two type A violations for 80065(a) Personnel Requirements and 87072(c) Personal Rights. A civil penalty is also assessed for a repeat violation. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Lisa Slusher 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 24-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, E SHAW AVE FACILITY NAME: MOLLIE'S HOUSEFACILITY NUMBER: 107202634


summary: Complaint Investigation - Substantiated

raw_content:
Investigation Findings:
13On the above date, LPA (Licensing Program Analyst) Lisa Slusher conducted a complaint inspection for the purpose of resolving the investigation into the above matter. The previous Therapist for the facility was not meeting mental health requirements for providing services. Additionally, the facility did not maintain needs and services plan explaining the mental health services required for youth. During the course of the investigation, LPA conducted interviews and reviewed documentation. Based on confidential interviews and documentation the allegation is SUBSTANTIATED. The facility is cited on this dat for STRTP Interim Licensing Standards for 87089.1 (d) Mental Health Program Approval SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Lisa Slusher 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 24-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, E SHAW AVE FACILITY NAME: MOLLIE'S HOUSEFACILITY NUMBER: 107202634

met_with: Torella Minor, Renee Lane


raw_content:
Investigation Findings:
13Licensing Program Analyst (LPA) Lisa Slusher conducted an unannounced visit to the Mollie's House STRTP, in order to deliver the findings of the above allegations and met with Administrator, Aaron Holloway. The above allegations were referred to Community Care Licensing for investigation. The investigation included interviews and a review of facility and foster children's records. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the allegations occurred. Therefore, the allegations are UNSUBSTANTIATED at this time. A copy of this report was discussed and provided along with appeal rights. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Lisa Slusher 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 3


raw_content:
Investigation Findings:
13On July 17, 2024, Licensing Program Analyst (LPA), Vanessa Galvan traveled to Mollie's House located in Fresno, CA to conduct an unannounced complaint inspection and met with Administrator Renee Lane. The purpose of the inspection was to deliver the findings for the above complaint allegations. The Department has investigated the above complaints. During the course of the investigation, LPA conducted confidential interviews. Based on interviews, it was determined that although the allegations may have happened or is valid, there is not a preponderance of evidence to provide the alleged violations did or did not occur, therefore the allegations are unsubstantiated. An exit interview was conducted discussing this report and the appeal rights. A copy of this report and appeal rights were provided to Renee Lane at the conclusion of the inspection. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Vanessa Galvan 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 STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORTCALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION FRESNO RO, E SHAW AVE This is an official report of an unannounced visit/investigation of a complaint received in our office on 04/25/2024 and conducted by Evaluator Vanessa Galvan PUBLICCOMPLAINT CONTROL NUMBER: 24-CR- FACILITY NAME:MOLLIE'S HOUSEFACILITY NUMBER: ADMINISTRATOR:MINOR, TORELLAFACILITY TYPE: ADDRESS: WEST BULLARDTELEPHONE: (559) 425- CITY:FRESNOSTATE: CAZIP CODE: CAPACITY:6CENSUS: 1DATE: 07/17/ UNANNOUNCEDTIME BEGAN: 01: PM MET WITH:Renee LaneTIME COMPLETED:02: PM 9Staff behavior posed as a risk to the minors while in care. INVESTIGATION FINDINGS: 13On July 17, 2024, Licensing Program Analyst (LPA), Vanessa Galvan traveled to Mollie's House located in Fresno, CA to conduct an unannounced complaint inspection and met with Administrator Renee Lane. The purpose of the inspection was to deliver the findings for the above complaint allegation. The Department has investigated the above complaint allegation. During the course of the investigation, LPA conducted confidential interviews. Based on information obtained and confidential interviews, it was determined that the preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED. The agency is being cited for Interim Licensing Standards, STRTP Article 06. Continuing Requirements, Personal Rights 87072(c)(16). See Attached LIC 9099D for further information. An exit interview was conducted discussing this report and the appeal rights. A copy of this report and appeal rights were provided to Renee Lane at the conclusion of the inspection. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Vanessa Galvan 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: 2 of Control Number 24-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION FRESNO RO, E SHAW AVE FACILITY NAME: MOLLIE'S HOUSEFACILITY NUMBER: 107202634


raw_content:
Investigation Findings:
13On August 28, 2024, Licensing Program Analyst (LPA), Vanessa Galvan traveled to Mollie's House located in Fresno, CA to conduct an unannounced complaint inspection and met with Administrator Renee Lane. The purpose of the inspection was to deliver the findings for the above complaint allegations. The Department has investigated the above complaints. During the course of the investigation, LPA conducted confidential interviews, file review, and obtained copies of documentation. Based on confidential interviews, it was determined that although the allegations may have happened or is valid, there is not a preponderance of evidence to provide the alleged violations did or did not occur, therefore the allegations are unsubstantiated. An exit interview was conducted discussing this report and the appeal rights. A copy of this report and appeal rights were provided to Renee Lane at the conclusion of the inspection. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Vanessa Galvan LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1


facility_name: MONTEREY COMPASS

summary: Facility Evaluation

raw_content:
Narrative:
On 10/29/2025 at 10: AM, Licensing Program Analysts (LPA) Shikya Belfield, LPA Paul Simeon, and LPA Omar Sawyer met with the above facility for the purpose of conducting components II and III of the Licensing Orientation. Representatives present during the orientation was Administrator Adeya Byrd, Administrator Dawn Henson, and Chief Program Officer Melissa Lawton. The following items were discussed: Component II · Client Assessments / intake policies and procedures / discharge planning / removal and transfers / continued services / community resources and their purposes / · Mental Health Program Approval and Head of Service - It was discussed who is assigned as Head of Service for the program and who they report to. · Organization - It was discussed who each person in the program would report to. From Direct Care Staff to chief program officer. · Administrator Assigned - Adeya Byrd who has their administrator certification. · Any missing forms or clarifications - emergency relocation sites have changes and new LIC610C will be submitted to the department by 11/7/2025. Form LIC 308 will be submitted with any changes will be submitted by 11/7/2025. The Component Three presentation was conducted and STRTP specific information and regulations were reviewed.

met_with: Dawn Henson


summary: Facility Evaluation

raw_content:
Narrative:
On 11/12/25 at 10: AM, Licensing Program Analyst (LPA) Paul Simien conducted an announced visit to the above facility. The purpose of this visit was to conduct the required Prelicensing inspection. LPA met with Dawn Henson, Administrator at the above facility to conduct the required annual inspection. LPA reviewed one staff files and completed the plant, staff, operations, and disaster preparedness sections of the STRTP prelicensing CARE tool. LPA Simien advised the facility to implement the following before accepting clients: Post clients personal rights in a place accessible. install client/representative complaint box in a place accessible. Perishable/non-perishable food supply, trash can with closed top for solid waste, make snacks and kitchen accessible for clients at any time. Desk space for each child. Personal closet space for each child. Supplies, materials, and reading material to implement activities. Non-slip rugs, hot water for bathroom sinks, toilet seat covers. Utility shut off and back-up generator instructions in disaster preparedness plan. Add anti-septic solution to first aid kite. At this time, the inspection is complete. LPA conducted an exit interview with Dawn Henson, Administrator.

visit_type: Prelicensing

met_with: Dawn Henson, Administrator


facility_name: MORGAN HILL STRTP

summary: Facility Evaluation

raw_content:
Narrative:
On 8/4/2022 at 9:00AM, a virtual meeting was conducted with an applicant for the purpose of providing technical assistance prior to the third revision of the application. Present at the meeting: Helga Wong, CCL Licensing Program Manager (LPM) Nelson Martinez, CCL Regional Manager (RM) Selena Hood, CCL Licensing Program Analyst (LPA) Marjana Jackson - System of Care Branch, Manager of Provider Development Unit, Present from Santa Clara County Department of Family and Child Services: Damion Wright - Assistant Director Amber Brandom Brian Hawkinson Gilbert Murillo LPM Wong led introductions. SCC and CCL representatives discussed the questions provided to CCL on 8/1/2022 (see LIC812). Assistant Director Wright informed CCL that the county would need a minimum of 45 days to resubmit the application. The call concluded at 9:50AM.

met_with: Damion Wright


facility_name: MOUNTAIN VALLEY CHILD AND FAMILY-BAR DU

raw_content:
Narrative:
Regarding the allegation that staffs' behavior posed a risk to clients in care, this concerned two areas - staff being on their phones and not paying attention to clients, and one male staff being inappropriate with one client in care. During interviews, all but one interview corroborated that the male staff was not inappropriate towards that client, even when the client was being inappropriate towards him. The staff met with the client and the client's therapist to help in setting boundaries. The staff made all attempts and efforts to stay away from that client. LPA found no basis in the accusation that this staff was inappropriate towards the client. LPA learned that staff used to be on their phones sometimes when they were not supposed to. The facility addressed this at the time by discussing phone rules with them while they are working. Even though staff would be on their phones sometimes during working hours, they also communicated with each other about work, or taking work notes. While the staff may or may not have been on their phones when they weren't supposed to be, there was not a preponderance of the evidence to prove that this did or did not pose a risk to clients in care, therefore LPA has found this allegation to be unsubstantiated. Regarding the allegation that staff withheld food from clients while in care, statements made during interviews were conflicting. All staff denied this allegation occurred. Two clients stated it occurred, however gave different stories about how it occurred. One client denied this ever occurred. Based on the conflicting information, LPA found that while this allegation may have occurred or is valid, there was not a preponderance of the evidence to prove that it did or did not occur, therefore LPA has found it to be unsubstantiated. For the allegation claiming that staff inappropriately restrained a client while in care, LPA also received conflicting information. Two clients stated they have not been in, nor observed an inappropriate restraint from any staff. All staff denied inappropriately restraining any client in care. One staff stated that one staff does grip too tightly during restraints, but does not bend or twist the client in an inappropriate way; the holds are appropriate. Based on the conflicting information, LPA found that while this allegation may have occurred or is valid, there was not a preponderance of the evidence to prove that it did or did not occur, therefore LPA has found it to be unsubstantiated. An exit interview was conducted with FM, and a copy of this report and appeal rights was emailed to FM with a read receipt which will serve as the record of receipt.

Investigation Findings:
13Licensing Program Analyst (LPA) Ayssa Burgess made an unannounced complaint investigation inspection at the facility and met with Faciltiy Manager (FM) Benny Rodriguez, who assisted with the inspection. LPA investigated this complaint by interviewing the facility Therapist, four staff, and three former clients on 1/24/2022, 1/25/2022, 1/26/2022, and 1/27/2022. LPA attemped to contact one more former client, however that client is out-of-state and LPA was unable to make contact. During LPA's interviews, LPA received mixed information. Statements made during this investigation included statements about one staff in particular making non-trauma-informed comments and behaviors towards clients. This was already addressed on 12/23/2020 (involving those same clients and staff), with a citation - 87072(d)(11). The facility cleared that deficiency. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jodean Greene LICENSING EVALUATOR NAME: Alyssa M Burgess 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: MOUNTAIN VALLEY CHILD AND FAMILY-BAR DUFACILITY NUMBER: VISIT DATE: 01/28/2022

met_with: Benny Rodriguez


raw_content:
Narrative:
Interviews were conducted and with six facility staff, four youth, three law enforcement officers, a medical professional and guardian from 5/3/2022- 7/19/2022. (See LIC 811, dated on 8/4/2022). Sacramento County Sheriff Report was obtained on 5/2/2022, resulting in an unsubstantiated allegation. Medical records were obtained on 5/24/2022. The allegation is whether Staff 1 (S1) sexually assaulted Youth 1 (Y1) in a bathroom at the facility. Y1 reported being sexually assaulted in a facility bathroom by S1. Y1 was interview by law enforcement then subsequently by Investigator Weaver. The details Y1 reported were not consistent in both statements. Y1 later admitted to lying about the incident due to being "mad". S1 denied the allegation. Additional interviews, three days of video surveillance and medical records did not corroborate or exclude the allegation. Based on the investigation, camera surveillance, records reviewed and interviews conducted, the complaint finding is UNSUBSTANTIATED at this time meaning that although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Exit interview was conducted. A copy of all reports and appeal rights were provided to the facility via email.

Investigation Findings:
13Licensing Program Analyst (LPA) Cindy Johnson arrived at the facility to conduct an unannounced complaint investigation inspection on 8/4/2022 at 1: PM. LPA Johnson spoke with Toby Briglia, Supervisor to discuss the findings of the complaint investigation and allegations stated above. LPA Johnson informed Mr. Briglia this case was investigated by Investigation Branch, Investigator Melissa Weaver. The investigation included: an initial 10-day unannounced complaint investigation inspection was conducted at the facility on 4/11/2022. Facility documents obtained include staff schedule, facility sketch, client rosters, Daily Communication Logs, Night Logs and chore chart. Facility video surveillance and facility's internal investigation were also provided. Facility documents regarding youths include Client Face Sheet, Identification and Emergency Information, Needs & Service Plans, incident report, Mental Health Services Residential Notes. Facility staff documentation obtained include Criminal Records Statement & Out of State Disclosure, Child Abuse Reporting Procedures, Statement Acknowledging Requirement to Report Child Abuse, Interpersonal Relationships and Program Boundaries Acknowledgement, completed training, Memo of Understanding, and exit interview. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jodean Greene LICENSING EVALUATOR NAME: Cindy Johnson 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: MOUNTAIN VALLEY CHILD AND FAMILY-BAR DUFACILITY NUMBER: VISIT DATE: 08/04/2022

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

met_with: Toby Briglia, Supervisor


raw_content:
Narrative:
According to the facility's Emergency Intervention Plan and Interim Licensing Standard 87095.22(f)(2)(a), written approval is required from the administrator or designee (not staff involved in the restraint) to continue a restraint past 15 minutes. In addition, C1 should have been checked for any possible injuries which was not assessed. Based on the investigation, records reviewed and interviews conducted, the complaint finding is SUBSTANTIATED at this time meaning that the allegation is valid because the preponderance of the evidence standard has been met. The facility is cited on the attached LIC 9099D for the violations of Interim Licensing Standard, Article 6, 87095.22(f)(2)(a), and 87095.01(a)(14) which is an immediate risk to the health and safety or personal rights of minors in care. An exit interview was conducted. A copy of all reports and appeal rights were provided to the facility via email. However, C1 was not receptive during this incident. The facility's internal investigation and interviews conducted with two staff and C1, were not able to confirm all of the statements made by staff to C1, it is not possible to determine if any statements were inappropriate. The last allegation is whether staff members yelled at C1 during an incident on 7/4/22. C1 admitted to yelling at staff during the incident and restraint on 7/4/22. C1 was able to provide details that C1 was yelling about. C1 made general statements that staff yelled at her, but C1 was not able to provide any details of the comments. Three staff denied yelling at C1. No specific details of statements made by staff to C1 were described or corroborated as "yelling". Therefore, it is not possible to determine if any staff yelled at C1 during the incident and restraint on 7/4/22. Based on the investigation, records reviewed and interviews conducted, the complaint findings are UNSUBSTANTIATED at this time meaning that although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Exit interview was conducted. A copy of all reports and appeal rights were provided to the facility via email.

Investigation Findings:
13Licensing Program Analyst (LPA) Cindy Johnson arrived at the facility to conduct an unannounced complaint investigation inspection on 10/20/2022 at PM. LPA Johnson spoke with Misty Jackson, Administrator to discuss the findings of the complaint investigation and allegations stated above. LPA Johnson informed Ms. Jackson this case was investigated by LPA Johnson. The investigation included: an initial 10-day unannounced complaint investigation inspection was conducted at the facility on 7/14/2022. Facility documents obtained include staff schedule, client rosters and facility's internal investigation. Facility documents regarding the youth include Client Face Sheet, Needs & Service Plans, incident report, Mental Health Services Residential Notes. Interviews and contacts were conducted and with four facility staff and one youth, from 7/14/2022- 9/21/2022. (See LIC 811, dated on 10/20/2022). The allegation is whether Client 1 (C1) was inappropriately restrained by three staff members on 7/4/22. The facility's internal investigation and interviews conducted with three staff and C1 confirm the restraint lasted for more than 15 minutes, despite not documenting the exact length of the restraint. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jodean Greene LICENSING EVALUATOR NAME: Cindy Johnson 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: MOUNTAIN VALLEY CHILD AND FAMILY-BAR DUFACILITY NUMBER: VISIT DATE: 10/20/2022

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

met_with: Misty Jackson, Administrator


raw_content:
Narrative:
One staff stated clients were not denied any meals, "unless they were off baseline and weren't acting right we'd be like, 'you get a snack,' it's too late for dinner." The staff stated that even when they made the snacks (items like chicken nuggets or something similar), the clients always ate something, and this happened on at least two occasions. One staff denied that clients had food withheld and stated if there were escalations during mealtime they would call another staff over to help and ensure the clients got to eat. Another staff stated if there were escalations during dinner time, the clients would get sandwiches. The Clinician and Administrator had no knowledge of food being withheld. Regarding the allegation that staff caused an injury to minor in care, confidential interviews revealed the following: one client does not remember that happening. One client stated they do not think this happened. Another client stated there was an escalation one time where a staff grabbed a client by the wrist, hard, which was not during a restraint. One client stated they had bruises and their arm hurt after being restrained. That client stated the staff intentionally hurt them and grabbed them hard. The client also stated they did not receive medical care for the injury, however this was unable to be corroborated. All staff and Administrators denied having knowledge that medical care was not obtained when any client needed it. One staff stated they never witnessed any staff hurting a client. One staff stated they have hurt a client before unintentionally during restraints due to clients squirming, however when told that the client was hurting, the staff loosened their grip or rearranged. When asked if the staff has ever lashed out physically to a client, the staff admitted that they may have held onto a client tighter. The Clinician stated that staff have, "probably," hurt a client during a restraint because that's the nature of them, "the fight between bodies." One staff thought they remembered one client's arm hurting after a restraint but did not remember the details. Both Administrators had no knowledge of this occurring. While staff may have unintentionally caused discomfort to clients during restraints, there was not a preponderance of the evidence that staff caused injury to them. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated. An exit interview was conducted with FM and a copy of this report and appeal rights was left with her. When one Administrator was asked what does taking clients' shoes after an AWOL have to do with safety, the Administrator stated, "if the client shoes were taken we would go back and look at why were the shoes taken for AWOLing, it would just have to be looking at who that kid was and why," which did not answer the question. The Administrator stated that sometimes clients AWOLed with no shoes on. The Clinician confirmed that staff took away clients' shoes, but stated clients were not made to go outside without their shoes. When LPA asked one staff what the circumstances would be that a client would not have their shoes, the staff stated, "if they AWOLed and they wouldn't have shoes." LPA asked the staff if that is because staff would take clients' shoes if they AWOLed, which they responded yes." This instruction came from the supervisors. Two staff and one Administrator stated that clients would also AWOL without their shoes. Interviews with staff revealed client shoes would be confiscated from clients for up to two days. When LPA asked one staff why the shoes are taken away, the staff stated, ""so it's easier to restrain [them] and not let [them] run away." When LPA asked one staff if a particular client had to be outside without shoes on, the staff confirmed and stated, ""we took [the client's] shoes off all the time, well not all the time, but it was more of a repeated offence in the same day, so we would take [the client's] shoes." Interviews with clients revealed that clients did have to be outside without their shoes on. One client stated that they would have to go to the, "timeout shelter," outside when the client was off baseline. This included when the client did not have any shoes on, and the client was not permitted to put them on. Another client stated when they went outside their shoes were confiscated, so the client was not able to put them on. The client also stated that on one occasion they had to go outside in the timeout shelter with no shoes on when it was rainy and cold outside. Staff confirmed that the timeout shelter was used to take timeouts for the clients. Another client stated their shoes were taken away for it, "being a danger," that they would AWOL, and they had to do PE outside with no shoes. Two clients stated the shoes would be confiscated for up to a week. LPA learned from interviews with staff that they are no longer taking clients' shoes, and this only happened in the past. Based on interviews LPA conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. Although the facility is now a Group Home, at the time of this allegation they were still a Short-Term Residential Therapeutic Program, therefore Short Term Residential Therapeutic Program Interim Licensing Standards, Version 3.1 (2020), Section 87072(d)(11), Personal Rights is being cited on the attached LIC 9099D. An exit interview was conducted with FM, and a copy of this report and appeal rights was left with her.

Investigation Findings:
13Licensing Program Analyst (LPA) Alyssa Burgess made an unannounced complaint investigation inspection at the facility and met with Facility Manager (FM) De'jana Crockett who assisted with the inspection. LPA investigatied this complaint by conducting confidential interviews with five clients, the Reporting Party, three staff, one Clinician, and two Administrators on 4/4/2023, 6/20/2023, 6/26/2023, 6/29/2023, 7/28/2023, 8/2/2023, and 8/3/2023. Confidential interviews with three staff, one Clinician, two Aministrators, and three clients revealed that clients got their shoes taken away for AWOLing. The shoes would be confiscated by staff and locked away from the clients. Two Administrators stated the shoes were taken away from clients after an AWOL for, "safety," reasons. One Administrator stated that clients would not be forced to be outside without their shoes on, however might choose to go outside without them on. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jodean Greene LICENSING EVALUATOR NAME: Alyssa M Burgess 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 STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORTCALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE This is an official report of an unannounced visit/investigation of a complaint received in our office on 06/16/2023 and conducted by Evaluator Alyssa M Burgess PUBLICCOMPLAINT CONTROL NUMBER: 23-CR- FACILITY NAME:MOUNTAIN VALLEY CHILD AND FAMILY-BAR DUFACILITY NUMBER: ADMINISTRATOR:MISTY JACKSONFACILITY TYPE: ADDRESS: BAR DU LANETELEPHONE: (916) 689- CITY:SACRAMENTOSTATE: CAZIP CODE: CAPACITY:6CENSUS: DATE: 08/16/ UNANNOUNCEDTIME BEGAN: 03: PM MET WITH:De'jana CrockettTIME COMPLETED:03: PM 9Staff caused injury to minor. Facility withheld food from minor in care. INVESTIGATION FINDINGS: 13Licensing Program Analyst (LPA) Alyssa Burgess made an unannounced complaint investigation inspection at the facility and met with Facility Manager (FM) De'jana Crockett who assisted with the inspection. LPA investigatied this complaint by conducting confidential interviews with five clients, the Reporting Party, three staff, one Clinician, and two Administrators on 4/4/2023, 6/20/2023, 6/26/2023, 6/29/2023, 7/28/2023, 8/2/2023, and 8/3/2023. Confidential interviews with one Administrator, one Clinician, two staff, and five clients revealed the following: One client stated when they had to be outside for long periods of time, the client would not get to eat. Two clients stated food was not withheld from them or other clients. One client stated on one occassion they were told they could not eat for misbehaving, and one client stated there were always planned meals, however they would not always follow the menu. That client also stated that sometimes during escalations, if they went long and late enough they would be sent to bed without dinner, but would instead get a snack. Other times the staff would be preoccupied and they would not get meals timely. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jodean Greene LICENSING EVALUATOR NAME: Alyssa M Burgess 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: 2 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: MOUNTAIN VALLEY CHILD AND FAMILY-BAR DUFACILITY NUMBER: VISIT DATE: 08/16/2023

met_with: De'jana Crockett


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Alyssa Burgess made an unannounced case management inspection at the facility and met with Administrator Misty Jackson and staff Sydney Barber, who assisted with this inspection. LPA and Staff conducted a walk-through of the facility. LPA observed three clients present. Two clients are home for visits, and one client was just recently discharged. LPA observed no deficiencies. CCL received an incident report on 12/14/2021 and 12/15/2021 which described a client being restrained by staff, and then by police officers, due to the client's behaviors and for safety. After the restraints, the client complained of wrist pain and was taken to the ER the following day where the client was diagnosed with a broken arm. The incident report states that it was after the restraint with the police officers that the client disclosed pain, and that it was the officers who were too rough with the client. LPA is investigating this incident report to gather more information and to speak with the client, staff, and Administrator. The client is currently not at the facility, but is on a family visit. LPA interviewed one client, one staff, one facility manager, and the Administrator. LPA collected staff schedules and contact information. Further investigation is required in order to resolve this case management. An exit interview was conducted with Administrator and a copy of this report was emailed to her with a read receipt which will serve as the record of receipt.

met_with: Misty Jackson


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Alyssa Burgess made an unannounced case management inspection at the facility and met with Facility Manager (FM) Jennifer Pacada who assisted LPA with the inspection. CCL received an incident report on 12/14/2021 and 12/15/2021 which described a client being restrained by staff, and then by police officers, due to the client's behaviors and for safety. After the restraints, the client complained of wrist pain and was taken to the ER the following day where the client was diagnosed with a broken arm. The incident report states that it was after the restraint with the police officers that the client disclosed pain, and that it was the officers who were too rough with the client. LPA investigated this incident report to gather more information and to speak with the client, staff, and Administrator. LPA investigated this Incident by conducting confidential interviews with four staff, one Administrator, two clients, and one biological parent on 12/20/2021, 12/24/2021, and 3/11/2022. Based on interviews provided, all statements were consistent in that staff at the facility did not break a client's arm. LPA found that it was a Law Enforcement Officer who broke the client's arm during a restraint the client was resisting. LPA found that the facility acted appropriately in handling this incident. No further investigation needed. An exit interview was conducted with FM and a copy of this report was emailed to her and three Administrators.

met_with: Jennifer Pacada


summary: Facility Evaluation

raw_content:
Narrative:
On 05/23/22, at 10: AM,, Licensing Program Analyst (LPA), Connie Goldie, met with Program Manager (PM)Misty Jackson to conduct an unannounced Annual/ Required inspection of a single story, four bedroom, 2 bath home. At 10: AM, Staff Francine Rivera greeted LPA Goldie and shared that PM Jackson was on her way in. PM arrived at 10: AM and stated that the current census was six clients. An Entrance Checklist was provided to the PA. LPA Goldie conducted the physical plant inspection with PM Jackson. The tour began at 10: AM in the laundry room. LPA Goldie observed a functioning washer and dryer, the Foster Youth Rights were posted along with youth in care schedules. LPA Goldie advised PM to obtain updated Foster Youth Rights posters. We proceeded to the office area, where LPA Goldie observed the license, the emergency intervention plan, the activity schedule and the menu for week 4. LPA observed two individual bedrooms with clean linens and a closet space. Each of these bedrooms had dressers with drawers that needed repair- missing knobs. The tour continued to the kitchen where PM opened all cabinets, perishable food for two days and non-perishable food for five days, adequate table ware and clean sink and stove were observed. Cleaning supplies were inaccessible and compliant. The living room/ dining area were spacious and allowed seating for clients and visitors and clear pathways were observed. Fire extinguisher pin in place, smoke detector and fire alarms tested and compliant. The home temperature was a comfortable 68 degrees. Bedrooms 3 and 4 had two beds with clean linens, dresser storage, and closet space. Water temperature tested at 111 degrees in bathroom within compliant range. Two bathrooms were observed to have soap and paper towels. Clients hygiene and extra linens available.Medication was adequately stored in locked cabinet in locked office. Outside LPA Goldie observed three swings, a space to take time as needed and an area free of debris. All windows and screens were in good condition. The three vehicles all contained first aid kits and were clean. Continued on LIC809C LPA Goldie interviewed 3 clients , C1, C2 and C3 and two staff PM and Mental Health worker. One Title Violation , type B is being issued today. Additionally, a technical advisory and a technical violation are also being issued. These are not deficiencies. An exit interview was conducted with PM Jackson at 4: PM. A copy of this report along with appeal rights were discussed and provided.

met_with: Misty Jackson Program Manager


summary: Facility Evaluation

raw_content:
Narrative:
On 05/24/2022, at 10: AM, Licensing Program Analyst (LPA) Connie Goldie met with Senior Program Director (SPD) Kamiko Lucas at Mouintain Valley Child & Family Services Administrative Office Bradshaw Road Ste 112, Sacramento, CA 95827 to complete the records review for this unannounced Annual inspection. LPA Goldie conducted record reviews including 6 staff files and 6 client files. LPA Goldie observed hard copy staff records. The client record review included hard copy files supported with virtual files in the Welligent system. Additionally, SPD Lucas provided restraint logs, LIC308 and LIC309 as requested. LPA Goldie requested that facility sketch be updated to reflect 4 bedrooms. Two Title 22 violations are being cited today. See LIC809D for details. Additionally, 1 technical advisory and 1 technical violation are being given. These are not deficiencies. An exit interview was conducted with Mental Health Coordinator Diane Carver at 5: PM. A copy of this report along with appeal rights was discussed and provided.


facility_name: MOUNTAIN VALLEY CHILD AND FAMILY-GERBER

raw_content:
Narrative:
This specific regulation allows for reasonable restrictions in the implementation of clients receiving and making confidential phone calls, including (2) "Restrict phone use in accordance with the facility discipline program. (3) Impose restrictions to ensure that phone use does not infringe on the rights of others or restrict the availability of the phone during emergencies." And (c)(8)(B) "All restrictions shall be documented in the child's needs and service plan or the facility's discipline policies, and be signed by the child's authorized representative." The facility discipline program includes "direction following" and timeouts when the client is "out of program" and escalated or dysregulated. Client Needs and Service Plans were obtained and reviewed, which includes detailed limitations for each client and is signed and authorized. According to the facility's policy " Client Phone Policy and Procedure", restrictions include: 1) "phone calls are not scheduled during school..." hours (onsite); 2) "...mental health group times..." 3) "...calls are limited to 15 minutes to ensure all residents the opportunity to make calls." In addition, it acknowledges these restrictions do not apply to "Exceptions: clients can place calls to CCL, a parent, guardian, attorney, CASA Worker, Foster Care Ombudsperson or placement worker at any time.) Details in client interviews were not corroborated due to the lack of specifics. So, it is not possible to determine whether all restrictions of phone usage were in compliance with the ILS. Based on the investigation, records reviewed and interviews conducted, the complaint finding is UNSUBSTANTIATED at this time meaning that although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. A copy of all reports and appeal rights were provided to the facility via email.

Investigation Findings:
13Licensing Program Analyst (LPA) Cindy Johnson arrived at the facility to conduct an unannounced complaint investigation inspection on 9/30/2022 at PM. LPA Johnson spoke with Misty Jackson, Facility Administrator to discuss the findings of the complaint investigation and allegations stated above. LPA Johnson informed Ms. Jackson this case was investigated by LPA Johnson. The investigation included: an initial 10-day unannounced complaint investigation inspection was conducted at the facility on 6/2/2022. Facility documents obtained include client rosters, facility menus and " Client Phone Policy and Procedures". Facility documentation obtained were youth Needs & Service Plans. Interviews were conducted with three facility staff and four youth, from 6/2/2022- 9/19/2022. (See LIC 811, dated on 8/4/2022). The allegation is whether the facility did not allow any of the clients to make or receive phone calls that should have been allowed. In all four client interviews, the clients were unsatisfied with the policy and routine, even when the policy was in compliance with Interim Licensing Standards (ILS) 87072 (c)(8) Personal Rights. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jodean Greene LICENSING EVALUATOR NAME: Cindy Johnson 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: MOUNTAIN VALLEY CHILD AND FAMILY-GERBERFACILITY NUMBER: VISIT DATE: 09/30/2022

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

met_with: Misty Jackson, Facility Administrator


summary: Complaint Investigation - Substantiated - 1 allegation

raw_content:
Narrative:
Based on the investigation, records reviewed and interviews conducted, the complaint finding is SUBSTANTIATED at this time meaning that the allegation is valid because the preponderance of the evidence standard has been met. The facility is cited on the attached LIC 9099D for the violations of Health & Safety Code, Article 5 1550(e) and Interim Licensing Standard, Article 6, 87065.2(b)(1) which is an immediate risk to the health and safety or personal rights of minors in care. An exit interview was conducted. A copy of all reports and appeal rights were provided to the facility via email.

Investigation Findings:
13Licensing Program Analyst (LPA) Cindy Johnson arrived at the facility to conduct an unannounced complaint investigation inspection on 10/12/2022 at --AM. LPA Johnson spoke with Tara Silafau, Program Director and Misty Jackson, Administrator to discuss the findings of the complaint investigation and allegations stated above. LPA Johnson informed both facility staff this case was investigated by LPA Johnson. The investigation included: an initial 10-day unannounced complaint investigation inspection was conducted at the facility on 9/15/2022. Facility documents obtained include client rosters, incident reports, and internal investigation. Interviews were conducted with four facility staff and six clients, from 9/13/2022- 10/3/2022. (See LIC 811, dated on 10/12/2022). The allegation is whether Staff 1 brought a vape pen with marijuana to the facility and smoked it while providing supervision. S1 offered the vape pen and was smoked by four clients inside the facility's barn. Three staff and four clients confirmed the incident occurred on 9/10/22. S1 admitted to the facility of "making a mistake" prior to S1's resignation. S1 also admitted to LPA Johnson of bringing the vape pen to the facility, smoking it, offering it to the youth, and allowing the youth to smoke it in S1's presence. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jodean Greene LICENSING EVALUATOR NAME: Cindy Johnson 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: MOUNTAIN VALLEY CHILD AND FAMILY-GERBERFACILITY NUMBER: VISIT DATE: 10/12/2022

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