facility_name: BEAR CREEK

raw_content:
Investigation Findings:
13On the above date, Licensing Program Analyst (LPA), Lidia Tinoco conducted an unannounced visit to the Bear Creek STRTP in order to deliver the findings of the above allegations and met with Administrator, Dawn Lee. On July 9, 2025, the above allegations were referred to Community Care Licensing for investigation. The investigation included an inspection of the Facility, confidential interviews, and review of records. Based on the investigation conducted, the department found that C1 was injured when S1 attempted to remove an item from C1's hand. Although an injury did occur, based on the confidential interviews conducted and review of records, the department concluded that the injury was accidental. Therefore, the allegations are Unsubstantiated at this time. A copy of this report was provided at the conclusion of the inspection along with appeal rights. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Lidia Tinoco LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

met_with: Dawn Lee, Administrator


state: CA

summary: Complaint Investigation - Unsubstantiated

raw_content:
Investigation Findings:
13On the above date, Licensing Program Analyst (LPA) Lidia Tinoco conducted an unannounced visit to the Bear Creek STRTP in order to deliver the findings of the above allegations and met with Head of Service, Veronica Ramirez. LPA Tinoco spoke with Administrator, Dawn Lee over the phone. On 08/21/25, The above allegations were referred to Community Care Licensing for investigation. The investigation included an inspection of the Facility, Interviews and a review of facility and children's records. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the allegations that Staff physically abused youth while in care resulting in bruises occurred. Therefore, the allegations are UNSUBSTANTIATED at this time. A copy of this report was discussed and provided at the conclusion of the inspection along with appeal rights. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Lourey Bartolome LICENSING EVALUATOR NAME: Lidia Tinoco 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

report_type: Complaint Investigation

met_with: Veronica Ramirez

complaint_status: unsubstantiated


summary: Facility Evaluation

raw_content:
Narrative:
On this date, Licensing Program Analyst (LPA) Lidia Tinoco traveled to the Creative Alternatives Main Office in Merced and conducted an unannounced Case Management for the Bear Creek and met with Director Brandi Boheme. The purpose of the inspection is to discuss multiple incident reports regarding medication errors by Staff. LPA Tinoco reviewed incident reports from the Bear Creek facility. It was discovered that there have been 3 medication errors due to staff for this facility (See LIC812 for details) in 2021. LPA Tinoco discussed with Director Brandi the concerns with the amount of incident reports regarding medication errors being received, LPA also addressed what the licensee has been done at the agency level to prevent this from happening, and what the ongoing plans are moving forward to minimize these incidents. Director Brandi stated that a company wide training on administration of medication. An exit interview was conducted, and a copy of the report and appeal rights were provided to the facility.

report_type: Facility Evaluation

visit_type: Case Management

met_with: Brandi Boehme


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced SB Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Eduardo Barragan on 11/10/2021 at 9 am. During the inspection, LPA Barragan met with Moraima Stewart, Facility Supervisor. LPA inspected the facility inside and out. LPA interviewed 1 staff on site at 10:24 am. LPA will be going to the corporate office in order to review the staff's files after the client interviews at the schools. LPA reviewed 3 of child's records on site at the facility. LPA reviewed 3 of child's psychotropic medications and medication records. LPA will be interviewing the children currently taking psychotropic medications at their schools after this inspection. LPA conducted exit interview with Moraima Stewart, Facility Supervisor at 11 am. LPA provided the Summary Report to Moraima, Facility Supervisor, upon completion. LPA Barragan is traveling to the main office in order to complete this inspection. No deficiencies were noted at this moment.

met_with: Moraima Stewart


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA) Lidia Tinoco traveled to the Bear Creek STRTP in Merced, CA for the purpose of conducting an unannounced annual inspection. LPA met with Administrator, Moraima Stewart and inspected the facility, inside and out. A physical plant inspection was completed and included the following checks. Facility grounds are clean and free of debris. Adequate indoor and outdoor activity space and materials observed. The facility is maintained at 75 degrees. All facility smoke detectors and carbon monoxide detectors are in appropriate working order. Facility maintains an adequate supply of perishable and non-perishable foods and appears to be following the posted menu. All required forms are posted. Five out of Six Clients are currently taking psychotropic medications, facility has the ability to keep Medications locked and centrally stored. Individual beds were observed with appropriate clean linens and are in good repair. Licensee has obtained Mental Health Certification Including the following: Mental Health Program Approval valid through September 24, 2021, a review was conducted on August 16-23, 2021 and have not been issued. Licensee has obtained National Accreditation through CARF valid through September 30, 2023. The facility has a county contract valid through June 30, 2022. Medical Certification valid From March 29, 2019 through March 28, 2022. No firearms or weapons are allowed in the facility. Facility appears to be meeting the terms and conditions of their license. No Deficiencies were cited on today's visit. A copy of this report was left with Jeanne Johnson.

visit_type: Annual


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA) Lidia Tinoco traveled to the Bear Creek STRTP in Merced, CA for the purpose of conducting an unannounced annual inspection. LPA met with Administrator, Moraima Stewart and Program Director Brandi Boehme. LPA Tinoco interviewed five out of six clients, one client refused to be interviewed. Seven Client files were reviewed. LPA Tinoco interviewed three staff and reviewed ten staff files. LPA Tinoco spoke with Administrator and discussed needs and services plans, and telephone policies of the facility including that any supervised calls need to be included in the needs and services plans with reasons why a decision was made to supervise the calls. One deficiency was cited on todays visit. Facility was cited for the Interim Licensing Standards (ILS) 87072(d) Personal Rights. A copy of this report was left at the facility at the end of inspection.

met_with: Moraima Stewart, Brandi Boehme


summary: Facility Evaluation

raw_content:
Narrative:
An unannounced Psychotropic Medication Inspection was conducted by Licensing Program Analyst (LPA) Tamara Melikian on April 19, 2023 at 9:00AM. This case management inspection is conducted pursuant to Health and Safety Code 1538.9(a)(2). During the inspection, LPA met with Dawn Lee, Administrator and inspected the facility inside and out. LPA reviewed 0 child's records and 1 staff personnel file on site at the facility. LPA reviewed 0 child's psychotropic medications and medication records as no children are currently placed in the facility. LPA interviewed 1 staff on site to discuss the facilities policies and procedures of operation. LPA interviewed no children as no children are currently placed in the facility. LPA provided a copy of the licensing report to Dawn Lee, Administrator. No deficiencies are being cited at this time. LPA conducted exit interview with Dawn Lee, Administrator.

met_with: Dawn Lee


summary: Facility Evaluation

raw_content:
Narrative:
On the above date, Licensing Program Analyst (LPA) Lidia Tinoco traveled to the Bear Creek STRTP in Merced, California for the purpose of conducting an unannounced Annual Inspection. LPA met with Assistant Executive Director Lisa Jacobs and inspected the facility, inside and out. A physical plant inspection was completed and included the following checks. Facility grounds are clean and free of debris. Adequate indoor and outdoor activity space and materials observed. The facility is maintained at 75 degrees. All facility smoke detectors and carbon monoxide detectors are in appropriate working order. Facility keeps some canned foods and non-perishables in the home, there is no perishable food in the house at this time but has access to a full pantry located at Merced Ranch where they can stock the facility should they chose to open the house again. All required forms are posted. Facility has the ability to keep medications locked and centrally stored. Individual beds were observed with appropriate clean linens and are in good repair. Licensee has obtained Mental Health Certification Including the following: The Facility has the Mental Health Certification valid through September 24, 2023. Licensee has obtained National Accreditation through CARF valid through September 30, 2023. The facility has a county contract valid through June 30, 2025. No firearms or weapons are allowed in the facility. Facility appears to be meeting the terms and conditions of their license. Currently the facility is inactive, therefore no children or staff are in placement therefore no files were reviewed. No Deficiencies were cited on today's visit. A Technical Assistance was discussed. A copy of this report was left with Lisa Jacobs.

met_with: Lisa Jacobs


facility_name: BEAZER

summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
CCL received another allegation that staff threatened minor. Confidential interviews revealed RC1 can be confrontational at times and it has been observed RC1 and S1 have had challenges with one another, however, de-escalation tactics, including re-direction have been used to correct RC1's behavior. Other confidential interviews revealed S1 was asked to move to another sister facility until management could determine how to proceed and create space between RC1 and S1. S1 has resigned and no longer works at any facility. Based on confidential interviews and record review, the allegation that S1 engaged in an altercation with RC1 and S1 and threatened minor may have occurred, however, it is not supported or proven by evidence. Therefore, these allegations are unsubstantiated at this time. An exit interview was conducted, and a copy of this report and appeal rights were provided to Residential Manager.

Investigation Findings:
13On July 14, 2022 at 03: PM, Licensing Program Analyst (LPA), Lisi Leon, met with OliveCrest - Beazer, Residential Manager, Franco Jakic to deliver the finding for the above stated allegations regarding the Short Term Residential Therapeutic Program (STRTP). LPA Leon conducted safety and health inspection on March 03, 2022 and no immediate health & safety concerns were observed. LPA Leon conducted interviews with Residential Manager (RM), three staff (S1, S2, S3), and three residential clients (RC1, RC2, RC3). LPA Leon obtained copies of the facility and client roster including schedules. Client record files were obtained for client involved in this allegation. On February 23, 2022, Community Care Licensing (CCL) received an allegation that staff engaged in an altercation with minor. Confidential interviews revealed client and staff were at dinner table and RC1 got upset and walked in S1 personal space. Confidential interviews shared S1 was eating dinner and had knife in hand in a downward motion and did not grab RC1 or any other client by the hands. Other confidential interviews revealed staff walked away from RC1 to create space. (Continued on 9099-C) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jennifer Smith LICENSING EVALUATOR NAME: Lisi Leon LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: BEAZERFACILITY NUMBER: VISIT DATE: 07/14/2022

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

met_with: Residential Manager Franco Jakic


raw_content:
Narrative:
On November 1, 2023, Community Care Licensing (CCL) received a complaint alleging that minor was sexually abused while in care. During investigation, a confidential interview denied that C1 was sexually abused while in care and added that C1 was in care for a short period of time. Confidential interview could not recall a report made by C1 about a sexual abuse incident involving C1 and the facility. Other confidential interviews stated that C1 left the facility on a continuous basis but there was no indication that C1 was sexually abused while in care due to C1 not disclosing sexual abuse allegations to facility staff. Other confidential interview denied that C1 was sexually abused while in care or knowing that a sexual abuse incident involving C1 occurred at the facility. Another confidential interview stated feeling safe in care, liking the placement, and denied witnessing sexual abuse while in care. C2, and C3 could not be reached for comment regarding the allegation that C1 was sexually abused while in care. C2, and C3 were reported being in care at time of the complaint and may or may have not been witnesses to the allegation previously mentioned. LPA could not determine whether C1 was sexually abused while in care due to receiving inconsistent information. Based on confidential interviews, the allegation that C1 was sexually abused while in care, may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. Therefore, the allegation is unsubstantiated at this time. Exit interview was conducted and a copy of this report along with the appeal rights was provided to Youth Specialist, Leilani Brown

Investigation Findings:
13On September 13, 2023, 12: PM, Licensing Program Analyst (LPA), Cynthia Urena met with Beazer Short Term Residential Therapeutic Program (STRTP) Youth Specialist, Lelanie Brown to deliver the investigative finding for the above stated allegation. On November 1, 2023, at 11: AM, LPA Daniel Mena initiated the investigation at the STRTP and collected pertinent documents from the STRTP program staff and client files. LPA Mena informed the STRTP that Special Investigator (SI) Georgina Tallagua would be leading the investigation. SI Tallagua interviews client #1 (C1). Additional interviews were conducted with an Administrator, five staff members (S1, S2, S3, S4, S5) and one client (C4). Two clients C2, C3 could not be reached after multiple attempts made by LPA Urena for interviews. LPA Urena reached C2's last known placement and was informed that C2 was no longer in care. C2's whereabouts are currently unknown, and C3 was reunified. For those reasons no further comments could be obtained by C2 or C3 about the allegation mentioned above. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Cynthia Urena LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION PACIFIC INLAND CR, MAIN ST., SUITE FACILITY NAME: BEAZERFACILITY NUMBER: VISIT DATE: 09/13/2023

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

met_with: Youth Specialist, Leilani Brown


raw_content:
Narrative:
Confidential interviews revealed that while C1 did AWOL from the home the Staff tried to get them to stay however C AWOLed anyway. Based on confidential interviews and record reviews, the allegation that lack of supervision resulting in C AWOLing, may have occurred, however, it is not supported or proven by evidence. Therefore the above allegation is unsubstantiated. A copy of this report, LIC 811, and appeal rights were given to Administrator Stacy Rougely.

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

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

met_with: Stacy Rougely


raw_content:
Narrative:
restrained minor in care, one confidential witness reported that a physical altercation occurred between a staff (S1) and client (C1) at the facility which resulted in C1 being physically abused and inappropriately restrained in care. Information gathered from interviews deny that staff physically abused and inappropriately restrained a minor in care. Records reviewed indicated that C1 had absconded from the facility and was found by S1. Multiple confidential witnesses confirmed that C1 exhibited aggressive behavior toward S1 and touched S1 and S1's personal property. Details gathered from confidential interviews deny that staff inappropriately restrained a minor in care. Further details gathered from interviews stated that C1 attempted to grab S1's personal property when both the client and staff fell to the floor. A physical altercation followed between C1 and another client in care. There were limited details and inconsistent information regarding which client got in a physical altercation with C1. Based on interviews and confidential information obtained during the course of this investigation, LPA received inconsistent information regarding the allegations. The allegations that facility staff physically abused minor in care and staff inappropriately restrained minor in care may have occurred, however is not supported, or proven by evidence. Therefore, the above allegations are unsubstantiated at this time. Exit interview conducted, appeal rights discussed and provided. A copy of this report along with LIC 9099-C were provided to facility representative.

Investigation Findings:
13On December 29, 2023 at 12:35 pm Licensing Program Analyst (LPA), Emina Preciado, met with Olive Crest, Beazer, Short Term Residential Therapeutic Program (STRTP), Youth Partner, Ivette Olmos to deliver the findings for the above stated allegations. LPA Lisi Leon conducted an inspection of the facility on December 12, 2022, at approximately 2:45 pm and no immediate deficiencies were observed. The investigation included interviews with two staff (S1 and S2), three foster youth (C1, C2, and C3), and one County Social Worker (CSW). In addition, county and facility records were reviewed. On December 2, 2022, Community Care Licensing (CCL) received two allegations alleging that facility staff physically abused minor in care and staff inappropriately restrained minor in care. Regarding the allegations that facility staff physically abused minor in care and staff inappropriately UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Natasha Dunlap LICENSING EVALUATOR NAME: Emina Preciado LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION PACIFIC INLAND CR, MAIN ST., SUITE FACILITY NAME: BEAZERFACILITY NUMBER: VISIT DATE: 12/29/2023

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

met_with: Ivette Olmos, Youth Partner


raw_content:
Narrative:
Confidential interviews revealed that the staff do not use physical punishment as a form of discipline. Confidential interview revealed that the usual form of punishment used at the facility included verbal redirection, de-escalation techniques and removing privileges and never any forms of physical punishment. There were no witnesses to the alleged incident and C1 could not be interviewed, therefore LPA could not confirm if the incident occurred or not. Based on confidential interviews, the allegation that S1 handled C1 in an inappropriate manner may have occurred, however, is not supported or proven by evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, and a copy of this report along with appeal rights was provided to Beazer Short Term Residential Therapeutic Program (STRTP), Youth Partner, Randy Davis.

Investigation Findings:
13On 05/15/24 at 11: AM, Licensing Program Analyst (LPA) Sarah Lo met with Youth Partner, Randy Davis, to deliver the finding for the above complaint allegation at Beazer Short Term Residential Therapeutic Program (STRTP). On 07/31/23, LPA Emina Preciado inspected the facility's physical plant, and no immediate health and safety hazards were observed. The investigation included interviews with one staff (S1), Residential Manager (RM), three Probation Officer (PO1) and four clients (C2, C3, C4 and C5), Client #1 (C1) was unable to be interviewed after several attempts due to C1's whereabouts are unknown. Clients' Needs and Services Plans and case notes were reviewed. On July 27, 2023, Community Care Licensing received an allegation that staff (S1) handled minor (C1) in an inappropriate manner. Specifically, it was reported that S1 grabbed C1's ear while walking through a tight doorway at the facility. (continued on LIC 9099c) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Sarah Lo LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE CRP RO, MAIN ST., SUITE FACILITY NAME: BEAZERFACILITY NUMBER: VISIT DATE: 05/15/2024

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

met_with: Youth Partner, Randy Davis


summary: Complaint Investigation - Substantiated - 1 allegation

raw_content:
Narrative:
Specifically, it was stated that S1 grabbed C3 by the shirt and pulled C3 towards to S1 and S1 made an inappropriate statement to C3. Confidential interviews confirmed that the physical and verbal altercation did happen. After C3 punched S1 in the face, S1 grabbed C3's shirt and pushed C3 in the chest leaving an approximate one-inch abrasion on C3's chest, while verbally threatening C3 by saying they will beat up C3. Based on confidential interviews, the preponderance of evidence standard has been met and the allegations that S1 handled C3 in an inappropriate manner and S1 spoke to C3 in an inappropriate manner are substantiated. The STRTP is being cited for violations of Interim Licensing Standards (ILS), version 5, section 87072(c)(1) for Personal Rights. An exit interview was conducted, appeal rights were explained, and a copy of this report and LIC 811 was provided to Youth Partner, Elsa Montesinos.

Investigation Findings:
13On 05/22/24 at 11: AM, Licensing Program Analyst (LPA) Sarah Lo met with Youth Partner, Elsa Montesinos, to deliver the findings for the above complaint allegations at Beazer Short Term Residential Therapeutic Program (STRTP). On 09/05/2023, LPA Emina Preciado inspected the facility's physical plant, and no immediate health and safety hazards were observed. The investigation included interviews with two staff (S1, S2), Residential Manager (RM) and Probation Officer (PO). Three clients declined to be interviewed and two clients were unable to be reached. Needs and Services Plans, Special Incident Report, Police Incident Report and case notes were reviewed. On August 28, 2023, Community Care Licensing received allegations stating that staff (S1) handled minor (C3) in an inappropriate manner and staff (S1) spoke to minor (C3) in an inappropriate manner. (continued on LIC 9099c) SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Sarah Lo LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE CRP RO, MAIN ST., SUITE FACILITY NAME: BEAZERFACILITY NUMBER: VISIT DATE: 05/22/2024

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

met_with: Youth Partner, Elsa Montesinos

complaint_status: SUBSTANTIATED


summary: Facility Evaluation

raw_content:
Narrative:
On October 22, 2021, at 9: AM Licensing Program Analyst (LPAs) Ronnesha Fountain and Leslie Covarrubias arrived at Beazer, Short Term Residential Program (STRTP). LPAs met with Residential Manager, Anne Lacy. The purpose of the visit is to conduct an annual inspection of the facility. At 9: AM, Residential Manager, Anne Lacy, led the physical inspection of the facility. The home is set up as follows: Bedroom #1- Was furnished with one twin bed. Sleeps one client. Bedroom #2- Was furnished with one twin bed. Sleeps one client. Bedroom #3- Was furnished with one twin bed. Sleeps one client. Bedroom #4- Was furnished with one twin bed. Sleeps one client. Bedroom #5- Was furnished with one twin bed. Sleeps one client. Bedroom #6- Was furnished with one twin bed. Sleeps one client. Bedrooms are arranged so that only one child is placed per room. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There is adequate drawer and closet space for children's belongings. A physical plant inspection was completed and included the facility's kitchen area, three refrigerators/ four freezers, food storage areas, client rooms, two bathroom/showers, and community gathering area and dining area. Facility grounds are clean and free of debris and observable hazards. Sports equipment/toys/books/games were observed for client's recreation time. There is adequate indoor and outdoor activity space. Facility smoke detectors and carbon monoxide detectors are in appropriate working order; fire extinguisher is properly charged and serviced. Licensee maintains an adequate supply of perishable and non-perishable foods and the menus were posted. At the time of inspection the facility license was observed to be posted by the front door. All required forms are posted including the Grievance Procedures, Visitation Policies, Personal Rights form, and Foster Care Ombudsperson poster. Medications are locked and centrally stored inside staff office. Individual beds were observed with appropriate clean linens, pillows, comforters, and mattresses in good repair. The hot water in the client's bathrooms was measured to be 137.8 for bathroom #1 and bathroom #2 was 135.5. Per the Residential Manager, no firearms or weapons are allowed in the facility. LPAs inspected the facility vehicle, and observed it was good repair. LPAs observed the First Aid Kit to be complete. LPAs conducted a client record review of six of six client files. All client's had a current needs and service plan in the file. Licensee has Mental Health Program Approval that is valid through 12/13/2021. Licensee has obtained National Accreditation that is valid through 10/31/2021. Licensing fee payments have been paid and there is currently a balance of $454 due November 27, 2021. Based on review of Physical Plant and Client Records, the facility is being cited for violation of the CCR 80088(e)(1); Fixture, Furniture, Equipment and Supplies , and Client Medical Records 80069(c)(1). An exit interview was conducted and a copy of this report, LIC 809D, LIC 811 and appeal rights were provided to Residential Manager, Anne Lacy.

met_with: Anne Lacy


summary: Facility Evaluation

raw_content:
Narrative:
On November 5, 2021, at 9:05am, Licensing Program Analyst (LPAs) Ronnesha Fountain and Carmen Escobar conducted an announced inspection. The purpose of the inspection was to complete the continuation inspection for STRTP annual inspection that was initiated on October 22, 2021. LPA's already completed the physical inspection and client records of the facility. During this annual inspection continuation LPAs reviewed nine staff files to ensure they contained all required documentation per Title Regulations and Interim Licensing Standards (ILS). LPAs conducted an interviews with S6, S9 and S10 staff, see LIC 811 for details. Based on interview with staff, the facility appears to be meeting Core Services/Supports requirements. Due to pending client interviews needed; this annual inspection will be continued at a later date. An exit interview was conducted and a copy of this report was provided to the residential manager Anne Lacy.


facility_name: BELOVED ONES

raw_content:
Narrative:
The Department received a report alleging that on the evening of 5/5/ S1 pushed C1 against a washing machine and scratched C1. C1 reportedly sustained superficial cuts on his hand from S1's nails. S1 denied the allegations. However, S1 admitted C1 obtained a small superficial scratch on the outside of C1's right index finger during the reported incident. S1 stated C1 walked into the garage to get a water bottle. S1 asked C1 to return the water bottle due to C1 having many half-used water bottles in his bedroom. C1 extended the water bottle to S1 and when S1 tried to take the water bottle from him, C1 pulled the bottle away from S1. S1 did not let go of the water bottle and resulted in S1's nail accidentally scratching C1. Statements obtained from interviews conducted with staff revealed the facility has a camera located in the kitchen which monitors the kitchen and the entrance to the garage where the incident took place. Staff reported the video was reviewed by facility management and no proof C1 was pushed into a washing machine by S1 was observed. Statements obtained from confidential interviews conducted did not reveal any witnesses to the alleged incident. Other clients were reportedly in their bedrooms or showering when the incident occurred. Based on information gathered from interviews conducted and records reviewed the allegation was unsubstantiated. Although the allegation may have happened or is valid the standard of the preponderance of evidence has not been met. Exit interview conducted and a copy of this report was provided to the facility representative. No deficiencies were cited during the inspection.

Investigation Findings:
13An unannounced follow up complaint inspection was conducted by Licensing Program analyst (LPA) Christopher Larios on 10/11/21 at 11: AM. During the inspection LPA Larios met with Director Thandi Smith. The purpose of the inspection was to deliver findings for the above-mentioned complaint allegation. During the course of the investigation LPA Larios conducted a interviews with one staff (S1) on 5/20/21, two staff (S2,S3) on 10/5/21, four clients (C1,C3,C4,C5) on 5/24/21, and four County Social Workers (CSW1,CSW2,CSW3,CSW5) on 10/5/21. Client (C2) declined to provide a statement regarding the allegation and one County Social Worker (CSW4) was unavailable for an interview (Reference Confidential Names list LIC811 dated 10/11/21). A records review was conducted on 5/20/21 and the following documetns were obtained: Staff Roster (LIC 500) and staff contact information, Facility Sketch, Client Roster and Client (C1) Needs and Services Plans and Special Incident Reports. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Deborah A Santos LICENSING EVALUATOR NAME: Christopher Larios LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: BELOVED ONESFACILITY NUMBER: VISIT DATE: 10/11/2021

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

met_with: Thandi Smith


raw_content:
Investigation Findings:
On February 4, 2022 at 2:00 p.m., Licensing Program Analyst (LPA), Karen McGee, delivered the findings of the complaint investigation to the facility. The LPA met with Administrator, Cindy Bertrand. On October 11, 2021, the Monterey Park Children's Residential Program (MPCRP) received a complaint with the above mentioned allegation. The investigation included confidential interviews that consisted of, but were not limited to: the Facility Manager; one client (see Confidential Names, LIC Ref. #1 dated February 4, 2022) at the facility on October 14, 2021; and one County Social Worker (CSW) via telephone on December 28, 2021. The LPA reviewed Special Incident Reports and the child's Needs and Services Plans. The investigation revealed that the allegation was denied by all the witnesses and the CSW had no concerns about the facility. The investigation revealed a statement that Ref. #1 was hit by another client at the facility. So, although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that an alleged violation of personal rights occurred, therefore the allegation is unsubstantiated. There are no deficiencies to be cited regarding these allegations. A copy of this complaint was emailed to the facility administrator. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Tira Logan LICENSING EVALUATOR NAME: Karen McGee LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

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

met_with: Cindy Bertrand


raw_content:
Narrative:
It was alleged that staff provided cigarettes to minors in care and staff allowed minor(s) to use marijuana while in care. The investigation revealed corroborating statements that staff were instructed to provide minors one cigarette per day. The Director purchased the cigarettes and were kept in the facility's office. Staff were also instructed to allow minors to take walks outside the facility, unsupervised, knowing that minors smoke marijuana or cigarettes during those walks. One minor reported being allowed to use marijuana while in care, but minor stopped using because minor wanted to transition to foster care and be adopted. The dispensing of cigarettes to minors by staff and permission to go on unsupervised walks ended after staff reported to Director that the minors were out of control. Minors started taking long walks or going for walks late at night, and minors started smoking in the facility's back yard. Director denied providing cigarettes to minors and explained that the cigarettes in the facility office were confiscated from minors. Director did not want the minors smoking at the facility, so minors were allowed to go out for walks, knowing that they were going to smoke marijuana or cigarettes. Director explained that allowing those walks was an attempt to work with the minors and not request for their removal. Director admitted to oversights during initial operation of the facility but has since made changes to the program by implementing a zero-tolerance policy to drugs and requesting notices to minors who refuse to follow rules. Based on the above information, the allegations are substantiated. The preponderance of evidence standard was met based on corroborating statements obtained. See LIC 9099D for deficiency citations issued under Short Term Residential Therapeutic Program (STRTP) Interim Licensing Standards (ILS). LPA discussed the findings and a plan of correction with the facility representative. An exit interview was conducted, and the following reports were provided at the conclusion of the LPA's inspection: LIC 9099, LIC9099C, LIC9099D, LIC Confidential Names Form and Appeal Rights forms. Minor was allowed weekend visitations with minor's potential foster-adoptive parents. Confidential interviews reveal that the minor had a parental relationship with the two staff and there was no inappropriate behavior or relationship witnessed by any of the interviewees. There was no corroborating evidence found to support any sexual relationship between the parties involved and no evidence that staff was pregnant. Based on the above information, the allegations are unsubstantiated because there was no evidence found to support it. Although the allegations may have happened or are valid, the standard of preponderance of evidence was not met. An exit interview was conducted, and a copy of this signed report, the Confidential Names form, and Appeal Rights forms were provided at the conclusion of the inspection.

Investigation Findings:
13On March 8, 2022 at 9:00AM, Licensing Program Analyst (LPA) Irene Yamamoto conducted a complaint inspection at the facility to deliver the finding of the allegations. LPA met with the facility representative named above. The allegations were investigated by Investigations Branch (IB) Investigator Mariana Lomeli who conducted confidential interviews with minors, staff and other related parties. Pertinent records were reviewed such as, but not limited to, Inter-agency placement reports, incident and law enforcement contact reports, Child and Family Team (CFT) notes and AWOL log. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Gustavo Garcia LICENSING EVALUATOR NAME: Irene Yamamoto LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: BELOVED ONESFACILITY NUMBER: VISIT DATE: 03/08/2022

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: Thandi Smith, Administrator


raw_content:
Narrative:
The investigation to the above allegations was conducted by this LPA and it consisted of, but not limited to a review of records, including the client's needs and services plans, medical records, and interviews with Staff members S1 on 9/10/2021, S3 on 9/16/21, S2 on 10/22/21, 2 of 4 clients C1 on 9/16/21, C2 on 9/28/21 (C3 was AWOL at the time of attempted interview and C4 declined to be interviewed) and CSW1 on 9/16/21 (Reference Confidential Names Form LIC 811, dated March 29, 2022). Facility staff denied the above allegations further indicating that every child placed in their facility is treated with respect, dignity and adheres to the Short-Term Residential Therapeutic Program Interim Licensing Standards. Complaint procedures were laminated and posted on the wall along with other Licensing required documents. Facility staff denied mismanaging medication however further disclosed that the only issues they have had were clients refusing to take their medication which was addressed appropriately by notifying agencies and clients physicians. S1 indicated that a former employee was hired as an Administrator after completing the Administrator course however after further review of their personal files it was revealed that the employee provided transcripts were fraudulent, and the employee was immediately terminated. The incident was documented and reported to the facility monitoring LPA. During personal file review, LPA Moroney observed health screening LIC503 and other required documents were up to date and filed accordingly. As to the allegation of staff speaking inappropriately and in a demeaning manner toward clients was denied by staff and clients. Information obtained from CSW1 did not corroborate the alleged allegations and further indicated that there are no concerns to the health and safety of the clients residing in the facility. Therefore, based on the information received, the above allegations are determined to be unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred, therefore the allegations are found to be unsubstantiated. Appeal Rights were provided and discussed with the facility Supervising Facility Manager. There are no deficiencies to be cited at this time. An exit interview was conducted and a copy of the report along with the (LIC 811) was left with Ms. Paredez.

Investigation Findings:
13On March 29, 2022, at 11: AM., Licensing Program Analyst (LPA) Winston Moroney, conducted a complaint inspection to the above facility and met with STRTP Facility Supervsing Facility Manager Tere Paredez. The purpose of the inspection was to deliver the findings for the above complaint allegations. On September 2, 2021, the California Department of Social Services Community Care Licensing Division received a complaint from Centralized Complaint and Information Bureau (CCIB) with the following allegations: Administrator handled a foster child inappropriately, Facility does not have complaint procedures posted, Facility staff mismanaged foster child's medication, Unqualified staff working, Facility staff does not have their health screening, and Staff speaks to the residents in an inappropriate and demeaning manner. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Deborah A Santos LICENSING EVALUATOR NAME: Winston Moroney LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: BELOVED ONESFACILITY NUMBER: VISIT DATE: 03/29/2022

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

met_with: Tere Paredez - Supervsing Facility Manager


raw_content:
Narrative:
Information obtained through confidential statements and S1 admission to breaking C1's cellphone is a Personal Rights violation. This is a violation of the Short-Term Residential Therapeutic Program Interim Licensing Standards regulation 87072(b)(11) Personal Rights: To be free of physical, sexual, emotional, or other abuse, and from corporal or unusual punishment, exploitation, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature including, but not limited to, interference with the daily living functions of eating, sleeping, or toileting, or withholding of shelter, clothing, or aids to physical functioning. If not corrected, it will have a direct and immediate risk to the health and safety of the children in care. Therefore, the above allegation is substantiated. The agency was cited, and a plan of correction was initiated. Appeal rights were provided and discussed with the Supervising Facility Manager. Copy of the report and the Confidential Name List (LIC811) dated March 29, 2022, was provided to the Supervising Facility Manager and an exit interview was conducted.

Investigation Findings:
13On March 29, 2022, at 10: AM., Licensing Program Analyst (LPA) Winston Moroney, conducted a complaint inspection to the above facility and met with STRTP Supervising Facility Manager. The purpose of the inspection was to deliver the finding to the above complaint allegation. On September 2, 2021, the California Department of Social Services Community Care Licensing Division received a complaint from Centralized Complaint and Information Bureau (CCIB) with the following allegation: Administrator damaged foster child's property. The investigation to the above allegations was conducted by this LPA and it consisted of, but not limited to a review of records, including the client's needs and services plans, medical records, and interviews with Staff members S1 on 9/10/2021, S3 on 9/16/21, S2 on 10/22/21, 2 of 4 clients C1 on 9/16/21, C2 on 9/28/21 (C3 was AWOL at the time of attempted interview and C4 declined to be interviewed) and CSW1 on 9/16/21 (Reference Confidential Names Form LIC 811, dated March 29, 2022). SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Deborah A Santos LICENSING EVALUATOR NAME: Winston Moroney LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: BELOVED ONESFACILITY NUMBER: 157806093

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

met_with: Tere Paredez - Supervising Facility Manager


raw_content:
Narrative:
It was alleged that facility staff was physically abusive to minors in care, and facility staff did not treat minors with dignity. Confidential statements obtained during the investigation were unable to corroborate the allegations as details obtained provided inconsistencies which did not support the allegations such as insistence and denial of witnessing or being subjected to the allegations. Facility staff also denied the allegations. Based on the information gathered, the allegations are unsubstantiated as the preponderance of evidence to prove the allegations was not met although the allegations may have happened or are valid. A copy of this report, Confidential Names Form and Appeal Rights were provided to the facility representative. There were no deficiencies cited during this inspection.

Investigation Findings:
13On March 30, 2022 at 11: AM, Licensing Program Analyst (LPA) Joshua Rarela conducted a follow-up complaint inspection to deliver the findings of a complaint investigation concerning the allegations above. LPA Rarela met and discussed the findings with the facility representative named above. During the course of the investigation, LPA Rarela interviewed the facility clients on 3/18/22 and 3/30/22 and facility staff on 3/18/22 (see Confidential Names Form dated March 30, 2022). LPA also reviewed documents including placing agency service logs and reports, facility client case plans, facility incident reports, and personnel records. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Gustavo Garcia LICENSING EVALUATOR NAME: Joshua Rarela LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: BELOVED ONESFACILITY NUMBER: VISIT DATE: 03/30/2022

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

met_with: Cindi Bertrand, Administrator


raw_content:
Narrative:
It was alleged that youth was inappropriately touched by another youth while in care. Confidential statements obtained during the investigation were unable to corroborate the allegations as details obtained provided inconsistencies and denial of witnessing or being subjected to the allegations. Facility staff also denied the allegations. LPA obtained the County Investigation Narrative. Based on the information gathered, the allegations are unsubstantiated as the preponderance of evidence to prove the allegations was not met although the allegations may have happened or are valid. A copy of this report, Confidential Names Form and Appeal Rights were provided to the facility representative. There were no deficiencies cited during this inspection.

Investigation Findings:
13On April 21, 2022 at 12: PM, Licensing Program Analyst (LPA) Janeth Chavez conducted a follow-up complaint inspection to deliver the findings of a complaint investigation concerning the allegations above. LPA Chavez met and discussed the findings with the facility representative named above. During the investigation, LPA Chavez interviewed the facility clients on 04/08/22 and 04/11/22 and facility staff on 04/21/22 (see Confidential Names Form dated April 21, 2022). LPA also reviewed documents including placing agency service logs and reports, facility client case plans, facility incident reports, and personnel records. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Yan Yeung LICENSING EVALUATOR NAME: Janeth Chavez LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: BELOVED ONESFACILITY NUMBER: VISIT DATE: 04/21/2022

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

met_with: Emanuel Butler


raw_content:
Narrative:
It was alleged that around April and May of 2022, a lack of supervision by staff resulted in one minor in care being assaulted and bullied by other minors in care. In an interview conducted, one child stated that for a period of time in the facility, some of the other children would physically bully them. The child stated that this ended after he began standing up for himself. The child stated that when he would get bullied, staff would attempt to redirect everyone by separating them. The child reported no injuries sustained during the incidents. The child stated that he felt safe in the home and that staff would always assist him if needed it. The child stated that there were usually 3-4 staff members working at any given time and that they were always nice and professional. In interviews conducted, two other children confirmed that staff were always kind and helpful. They both felt safe in the home and felt like they could always ask staff for assistance if needed. Both other children also stated that when fights or disagreements would occur in the home, staff would redirect the children and take away privileges as a form of discipline if applicable. In an interview conducted, one staff member stated that all employees were vigilant with their supervision and would break up disagreements or fights as soon as they started. Fights have not resulted in injuries and the children generally get along for the most part. Another staff member interviewed confirmed that staff were always supervising the children and that any physical disagreements would be redirected immediately. The children would get into arguments every once in awhile but it has never resulted in serious injuries. A review of records revealed no indications that there are any issues with a lack of supervision in the home. Based on interviews conducted and records reviewed, there is not a preponderance of evidence to suggest that the above allegation occurred. Although the allegation may have happened or may be valid, the preponderance of evidence standard has not been met. Therefore, the allegation is deemed UNSUBSTANTIATED. An exit interview was conducted and a copy of this report, along with the Licensee's Rights, were provided to the Licensee.

Investigation Findings:
13On August 31, 2022 at approximately 12: PM, Licensing Program Analyst (LPA) Raymond Wu conducted an unannounced complaint inspection visit at the facility for the purposes of concluding an complaint investigation. LPA met with the representative named above and discussed the purpose of the visit. As part of the investigation, LPA conducted interviews with clients and staff on 05/25/22 and 08/18/2022. Records were reviewed on 07/15/22 and 08/30/22. (Continued) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Yan Yeung LICENSING EVALUATOR NAME: Raymond Wu LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 32-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, CORPORATE CNTR DR. #200A MONTEREY PARK, CA FACILITY NAME: BELOVED ONESFACILITY NUMBER: VISIT DATE: 08/31/2022

met_with: Tere Paredes, Supervising Facility Manager


facility_name: BELOVED ONES 10

summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Shikya Belfield conducted an announced meeting regarding the application for Beloved ones 10. Present during this meeting were Licensing Program Managers (LPM) Carolyn Flynn, LPM Marjana Jackson, LPA Kristin Pierotti, LPA Cynthia Galindo, and Licensee Thandi Smith. The purpose of this meeting is to discuss any concerns, ask questions, and give or provide any needed clarification. During this meeting the following was discussed, program statement updates, submitted revisions, outstanding forms, and questions regarding timelines of completion. LPA Belfield discussed missing information regarding LIC308 administrator designation form, LIC610C emergency disaster preparedness form, and county letter of support. LPA explained that there are other missing forms and that program statement was in the final review process. LPM Flynn asked for clarification regarding the program statement that CCL currently has, will be used for all of the Licensees other programs. Licensee confirmed that it would be. No other concerns were raised. LPA's thanked Licensee for the updated revisions and expressed appreciation for the new formatting and added information to the program statement. LPA agreed to submit the request for outstanding items in an email separate from the request for the revisions of the program statement. Licensee asked if there was time line in which the review would be complete. LPA explained that no specific time and date could be provide for completion of the review however, they would do their best to provide the response as quickly as possible. This meeting was concluded.


summary: Facility Evaluation

raw_content:
Narrative:
On 8/6/2025 at 10: AM, Licensing Program Analysts (LPA) Shikya Belfield and LPA Omar Sawyer met with the above facility via Teams to conduct components II and III of the Licensing Orientation process. Representatives present during the orientation was Licensee Thandi Smith. The following items were discussed: Component II · Client Assessments - Depending the clients and the type of assessment needed, this process will be completed by the Head of Service, Program Psychiatrist, Mental Health Program Director, or referred to the appropriate licensed professional. · 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 (chain of command, roles and responsibilities) - It was discussed who each person in the program would report to. From Direct Care Staff to Program Director. · Administrator Assigned - Gina Smith on the 308 and Salih Robinson as assigned Administrator. · Any missing forms or clarifications - Licensee submitted forms LIC 610C with the added second location per required by revision request and LIC308 with new designee. The Component Three presentation was conducted and STRTP specific information and regulations were reviewed. An exit interview was conducted, and a copy of this report will be sent to Licensee Thandi Smith.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Celeste Aparicio and Kaitlyn Wong conducted a Pre-licensing inspection and met with Facility Director, Thandi Smith. The entire home was toured, inside and out. The applicant is interested in providing care for a capacity of six children, ages seven - seventeen years, ambulatory only. The home is set up as follows: This is a two- story home with three bedrooms, three bathrooms, a living room, a dining-room, and kitchen. Bedroom # 1 - occupied by minor (two twin beds, two dressers and shared closet space, single standing lamp). Bedroom # 2 - occupied by minor ( two twin beds, two dressers and shared closet space, single standing lamp) Bedroom # 3 - occupied by staff used as a staff office/ therapy room. There were appropriate furnishings in the home. There was a fireplace in the living room that was fenced properly. Three full bathrooms and one full bathroom with be utilized specifically for staff. The faucets that will be used by the children were tested and delivered hot water at a temperature of 127.5 degrees. The facility was made aware of this issue and is advised to put up warning signs advising clients of hot water temperatures. The facility is aware of having two day perishable and 7 day non - perishable food supply. Technical Advisories were issued for Sections 80088(e)(2) and 87072.2(a)(3) as a reminder for water temperature and location of complaint procedures. The trash cans to be used by clients and in the kitchen were covered to stop the transmission of communicable diseases or odors. The smoke detectors and carbon monoxide alarms were tested and are operable. LPA reminded the facility that emergency telephone numbers, Personal Rights, food menu needed to be posted in a prominent location. The home will have a locked container and cabinet where medications and or contraceptives will be stored. Disinfectants and cleaning solutions were stored in a location that will be inaccessible to children. The storage area for poisons was locked and accessible only to employees. The first aid kit was checked and found to be complete. The front and backyard were inspected and found cleared of hazards. There were no pools and/or bodies of water on the premises. The applicant stated that there are no firearms in the home. LPAs requested an updated copy of the LIC500 and conducted [1] interview with staff to discuss intake procedures and trauma informed care of the program. An exit interview was conducted, and a copy of this report was provided to Facility Director, Thandi Smith.

visit_type: Prelicensing

met_with: Director, THANDI SMITH


facility_name: BELOVED ONES 11

raw_content:
Narrative:
between S1 and C1. During investigation, confidential interviews reported that prior to their arrival, S1 was asked by other facility staff not to respond. Confidential interviews reported that S1 ignored this request and responded regardless. Confidential interviews reported that upon arrival to the facility, S1 was asked by other staff to not take the lead in de-escalating C1, as it was suspected S1 and C1 had animosity against each other. Confidential interviews reported that S1 again dismissed any such request. Other confidential interviews reported that upon arrival to the facility, S1 did not attempt to de-escalate C1, but instead instigated C1 by reminding C1 that C1 had threatened physical violence upon S1 at a previous occasion and S1 encouraged C1 to follow through on this threat. Confidential interviews continued reporting that S1 and C1 immediately became physically entangled and that S3 and S4 attempted to separate S1 and C1. Confidential interviews indicated that prior to being separated, S1 punched C1 with a closed fist on at least one occasion and made contact with C1's head and/or body area. Confidential interviews disclosed that after a review of the facility's video surveillance footage of this incident, it was observed that S1 punched C1. Based on the confidential interviews, a review of pertinent documentation and a review of video footage, the preponderance of evidence standard has been met, and the allegation that facility staff punched a minor in care is substantiated. The facility is being cited for violation of ILS 87072(c)(1) Personal Rights (See attached 9099D). An exit interview was conducted. A copy of this report, LIC 809D and appeal rights were explained and given to Supervising Facility Manager Tiana Bolden.

Investigation Findings:
13On 04/17/2025, at 09: AM, Licensing Program Analysts (LPAs) Joon Choi and Claudia Aguilera conducted an unannounced visit at Beloved Ones Short Term Residential Treatment Program (STRTP) and met with Supervising Facility Manager Tiana Bolden to deliver the investigative finding for the allegation listed above. On 02/26/2025, Community Care Licensing received an allegation that facility staff punched a minor in care. On 03/06/2025, LPA Joon Choi arrived at the facility, conducted a health and safety inspection, and obtained pertinent documents. No immediate health and safety hazards were observed. In addition, LPA interviewed clients 1 and 2 (C1, C2) and staff 1, 2, and 3 (S1-S3). Staff 4 (S4) who is no longer employed at the facility, did not return any of LPA's requests for communication. In regard to the allegation that facility staff (S1) punched a minor in care (C1); it was reported that S1, S3 and S4 arrived at the facility because assistance was requested. It was further reported that upon arrival, S1 engaged in a verbal altercation with C1, and that this incident escalated into a physical altercation. CONTINUED ON THE NEXT PAGE SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Joon R Choi LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE CRP RO, MAIN ST., SUITE FACILITY NAME: BELOVED ONES 11FACILITY NUMBER: VISIT DATE: 04/17/2025

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

met_with: Supervising Facility Manager, Tiana Bolden


summary: Facility Evaluation

raw_content:
Narrative:
On August 20. 2024, Licensing Program Analyst (LPA) Babatunde Aborchie and Licensing Program Manager (LPM) Abdoulaye Traore met with applicant Thandi Smith for component II. LPA and LPM went over revisions needed for the application prior to licensure. Applicant is applying for STRTP license. LPA and LPM gave a copy of the LIC 184, Notice of Incomplete Application, and additional correspondence to assist with the revisions needed to the application. Copy of this report was provided to applicant.


summary: Facility Evaluation

raw_content:
Narrative:
On September 20. 2024, Licensing Program Analyst (LPA) Babatunde Aborchie and Licensing Program Manager (LPM) Abdoulaye Traore reviewed corrections made by applicant Thandi Smith during the component II. LPA and LPM went over revisions of the corrections made prior to licensure. Applicant is applying for STRTP license. Copy of this report was provided to applicant.


summary: Facility Evaluation

raw_content:
Narrative:
On October 3, 2024, Licensing Program Analyst (LPA) Babatunde Aborchie and Licensing Program Manager Abdoulaye Traore began a pre-licensing inspection for a Short Term Residential Therapeutic Program (STRTP) license. LPA and LPM met with director Thandi Smith, administrator, Philip Cook and operations manager, Salih Robinson who led a tour of the home. The facility was toured both inside and out with the applicants. Currently there is no child placed in the home. The applicant is applying to serve six minor and nonminor dependents children (NMD). The residence is a four-bedroom two story-house with three bathrooms. The downstairs area consists of a living room, a kitchen, dining area, laundry room, storage down the stairs, a bathroom, the garage, and the backyard. There was one bedroom and it consists of two twin-size beds; it will sleep two clients. Upstairs consists of 3 bedrooms and two bathrooms. The 2 bedrooms will be utilized for clients, they consist of two twin-size beds in each room, and they will sleep two clients per room. In addition to the upstairs bedrooms, the master bedroom was utilized as a locked office and it consists of office desks, furniture, a bathroom, and a room to store medications and files. Bedrooms were arranged so that no more than two clients share a room, and there was one child per bed. No room commonly used for other purposes was used as a bedroom, and no bedroom serves as a passageway to another room. There were adequate drawers and closet space for children's belongings. Towels and linens were stored in a cabinet by the clients' bedrooms. The smoke detectors and carbon monoxides were checked and were working properly. The fireplace was in the living room area, and it was properly screened. Telephone service and appliances were in a working order. All hazardous items have been properly made inaccessible to areas where clients would have access. The medications and sharp objects/knives will be locked and stored in a storage box in the office closet. Cleansers/chemicals were locked and stored in the laundry room. The first aid kit was in a cabinet in the kitchen area by the kitchen sink, accessible and contained all required items. There were no guns or weapons as stated by applicant at this time. The hot water temperature was tested and noted to be 111 degrees. There was adequate food storage supply of two days of perishable foods and a week of non-perishable food. Proper storage of all food was discussed. Trash cans for storage of solid waste have tight fitting lids. The Facility Sketch, Emergency Disaster Plan, visitation policy and Personal Rights were posted. There were no pool or other body of water and the backyard where clients will have access to play was completely fenced and free of hazards. Currently, the facility is appropriate for a capacity of six ambulatory clients, ages seven to seventeen and non-minor dependents. All requirements were met at this time. Licensing Program Manager will complete a final review prior to issuing a provisional license. Exit interview was conducted and a copy of this report was provided the director, Thandi Smith.


summary: Facility Evaluation

raw_content:
Narrative:
On April 3, 2025, Licensing Program Analysts (LPAs) Babatunde Aborchie and Claudia Aguilera began a post-licensing inspection for Beloved Ones Short Term Residential Therapeutic Program (STRTP). LPAs met with Salih Robinson, Operations Manager, who led a tour of the home. The facility was toured both inside and out with the manager. Currently there is one child in placement in the home. The residence is a four-bedroom two story-house with three bathrooms. The downstairs area consists of a living room, a kitchen, dining area, laundry room, storage down the stairs, a bathroom, the garage, and the backyard. There was one bedroom, and it consists of one twin-size bed; it was vacant. Upstairs consists of 3 bedrooms and two bathrooms. Bedroom #2 the master bedroom was utilized as a locked office and it consists of office desks, furniture, a bathroom, and a room to store medications and files. Bedroom #3 consists of one twin bed, it was vacant. Bedroom #4 consist of one twin bed; it sleeps one client. Bedrooms were arranged so that no more than two clients share a room, and there was one child per bed. No room commonly used for other purposes was used as a bedroom, and no bedroom serves as a passageway to another room. There were adequate drawers and closet space for children's belongings. Towels and linens were stored in a cabinet by the clients' bedrooms. The smoke detectors and carbon monoxides were checked and were working properly. The fireplace was in the living room area, and it was properly screened. Telephone service and appliances were in a working order. All hazardous items have been properly made inaccessible to areas where clients would have access. The medications and sharp objects/knives were locked and stored in a storage box in the office closet. Cleansers/chemicals were locked and stored in the storage under the staircase. The first aid kit was in a cabinet in the kitchen area by the kitchen sink, accessible and contained all required items. There were no guns or weapons as stated by the manager at this time. The hot water temperature was tested and noted to be 109 degrees. There was adequate food storage supply of two days of perishable foods and a week of non-perishable food. Proper storage of all food was discussed. Trash cans for storage of solid waste have tight fitting lids. The Facility Sketch, Emergency Disaster Plan, visitation policy and Personal Rights were posted. There were no pool or other body of water and the backyard where clients will have access to play was completely fenced and free of hazards. LPA interviewed one of one client and two staff. Based on this post-licensing inspection of the home, no deficiencies were found during this inspection. An exit interview was conducted, a copy of this report was provided to the operation manager Salih Robinson.

met_with: Salih Robinson


summary: Facility Evaluation

raw_content:
Narrative:
On October 13, 2025, Licensing Program Analyst (LPA) Babatunde Aborchie began an annual/required inspection for Beloved Ones Short Term Residential Therapeutic Program (STRTP). LPA met with Supervising Facility Manager (SFM), Tiana Bolden who led a tour of the home. The facility was toured both inside and out with the SFM. Currently there is no child placed in the home; the last placement was moved after turning 18-year-old. The residence is a four-bedroom two story-house with three bathrooms. The downstairs area consists of a living room, a kitchen, dining area, laundry room, storage down the stairs, a bathroom, the garage, and the backyard. There was one bedroom, and it consists of one twin-size bed; it would sleep on client, it was vacant. Upstairs consist of 3 bedrooms and two bathrooms. The 2 bedrooms will be utilized for clients, they consist of one twin-size bed in each room, and they will sleep one client per room. In addition to the upstairs bedrooms, the master bedroom was utilized as a locked office and it consists of office desks, furniture, a bathroom, and a room to store medications and files. Bedrooms were arranged so that no more than two clients share a room, and there was one child per bed. No room commonly used for other purposes was used as a bedroom, and no bedroom serves as a passageway to another room. There were adequate drawers and closet space for children's belongings. Towels and linens were stored in a cabinet by the clients' bedrooms. The smoke detectors and carbon monoxides were checked and were working properly. The fireplace was in the living room area, and it was properly screened. Telephone service and appliances were in working order. All hazardous items have been properly made inaccessible to areas where clients would have access. The medications and sharp objects/knives were locked and stored in a storage box in the office closet. Cleansers/chemicals were locked and stored in the storage downstairs. The first aid kit was in a cabinet in the kitchen area by the kitchen sink, accessible and contained all required items. There were no guns or weapons as stated by the SFM at this time. The hot water temperature was tested and noted to be 113 degrees. There was adequate food storage supply of two days of perishable foods and a week of non-perishable food. Proper storage of all food was discussed. Trash cans for storage of solid waste have tight fitting lids. The Facility Sketch, Emergency Disaster Plan, visitation policy and Personal Rights were posted. Five staff files were reviewed, and met requirements. There was no pool or other body of water and the backyard where clients have access to play was completely fenced and free of hazards. All requirements were met at this time. Based on this annual/required inspection of the home, no deficiencies were found during this inspection. An exit interview was conducted, and a copy of this report was provided to the Supervising Facility Manager, Tiana Bolden.


summary: Facility Evaluation

raw_content:
Narrative:
On December 3, 2025, Licensing Program Analyst (LPA) Babatunde Aborchie met with Beloved Ones Short Term Residential Therapeutic Program (STRTP), Facility Administrator Philip Cook to conduct a case management visit following the incident report dated November 20, 2025. LPA interviewed Client 1 (C1) two Supervising facility managers (FM1 and FM2), Administrator. LPA will review documentation and interviews for final determination of findings.

met_with: Philip Cook


facility_name: BELOVED ONES 12

raw_content:
Narrative:
This is an amended LIC9099C to the original issued on 05/23/2025. Confidential interviews confirmed that S4 violated facility policy which states that staff should be "hands off". Staff are not permitted to use physical force toward clients. If a restraint is required, it is only used as a last resort after attempting de-escalation techniques, and two staff members are to be present to perform the restraint. Confidential interviews reported that S4 was the only staff present at the facility when the incident occurred, and corroborating statements supported by evidence, showing that S4's self-defense claims were disproved. It was reported that S4 did not attempt to evade, separate from C1, or de-escalate the situation. Video footage corroborated that S4 was "antagonizing" C1. In addition, S4 initiated the confrontation and aggressively walked towards C1 multiple times. Furthermore, the evidence shows S4 physically assaulting C1 by wrestling and throwing C1 to the ground resulted in C1's broken arm. The aggressive behavior shown by S4 toward C1 indicated that S4 did not provide trauma-informed care or show a regard for C1's well-being, showing S4 acted in a way to violate licensing regulations that state minors are to be treated respectfully. Moreover, based on the evidence, S4 was arrested for PC 243(D)- Battery with serious bodily injury and PC 273a(a)- child abuse with possible great bodily injury. Based on confidential interviews and supportive evidence, the allegation that a Minor (C1) sustained broken arm while in care and facility staff (S4) do not treat minor (C1) with dignity and respect is substantiated. The preponderance of evidence standard has been met. The Short Term Residential Therapeutic Program is cited for violation of Interim Licensing Standards (ILS) Personal Rights (c)(16), which states (c) The licensee shall ensure that each child, regardless of whether the child is in foster care, is accorded the personal rights... (16) To be free of physical, sexual, emotional, or other abuse, and from corporal or unusual punishment, exploitation, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature ... An Enhanced Civil Penalty (ECP) determination is pending. If an ECP is assessed a CCL representative will return to the facility to deliver the penalty assessment. The Program Administrator approved the assessment of this Enhanced Civil Penalty. Therefore, an ECP was issued to this facility in the amount of $2,500 on the {LIC809 and LIC421}. A copy of this report, LIC 811, and appeal rights were provided to Facility Manager Shaun Dwyer.

Investigation Findings:
13On May 23, 2025, at 2: PM, Licensing Program Analyst (LPA) Jessica Peete made an unannounced visit to Beloved Ones Short Term Residential Therapeutic Program (STRTP) and met with Facility Manager Shaun Dwyer to deliver the investigative findings for the allegations mentioned above. The investigation was conducted by Special Investigator (Inv) Jesus Gonzalez of the Community Care Licensing (CCL) Investigations Bureau. The investigation included interviews with the facility staff (S1-S3), clients in care (C1-C3), and the County Social Worker (CSW). Inv Gonzlez attempted to interview S4, but S4 declined to provide a statement. On February 26, 2025, Community Care Licensing (CCL) received allegations that a minor (C1) sustained a broken arm while in care and facility staff (S4) do not treat minor (C1) with dignity and respect. It was alleged that S4 and C1 got into a physical altercation which resulted in in C1 sustaining a dislocated left elbow and a fractured radius bone. Inv Gonzalez obtained sufficient evidence to support the allegations. (Continued on LIC 9099C) SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Cheraki Davis LICENSING EVALUATOR NAME: Jessica M Peete LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION PACIFIC INLAND CR, MAIN ST., SUITE FACILITY NAME: BELOVED ONES 12FACILITY NUMBER: VISIT DATE: 05/23/2025

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

met_with: Shaun Dwyer Facility Manager


summary: Complaint Investigation - Substantiated

raw_content:
Narrative:
In regard to the allegation, it was specifically alleged that staff went to wake C1 up for school in the morning and found an unknown female minor in bed with C1. During the investigation, a confidential interview stated there was an unknown female minor in C1's bed. The confidential interview did not know how the unknown female minor got in the room. Another confidential interview was conducting a room check during morning shift change and found the unknown female minor. The confidential interview indicated that C1 snicked the unknown minor in by distracting the staff. A confidential witness observed on facility camera that C1 brought in the unknown female minor and staff was unaware. Based on confidential interviews, a review of pertinent documentation and a review of the facility's video surveillance footage, the preponderance of evidence standard has been met, and the allegation that staff are not adequately supervising minors is substantiated. The facility is being cited for violation of Title 22, Division 6, Chapter 1, Article 06. Continuing Requirements Responsibility for Providing Care and Supervision, (a) The licensee shall provide care and supervision as necessary to meet the client's needs (see LIC 9099D). An exit interview was conducted. A copy of this report (LIC 9099), (LIC 9099D) and appeal rights were explained and given to facility representative.

Investigation Findings:
13On October 22, 2025, Licensing Program Analyst (LPA) Babatunde Aborchie arrived at Beloved Ones 12, Short Term Residential Therapeutic Program (STRTP) and met with Jonathan Bethel to deliver the investigative finding involving STRTP and clients as listed on the Confidential Name List (LIC 811). On May 14, 2025, a complaint report was referred to Community Care Licensing (CCL) alleging that staff are not adequately supervising minors. On May 27, 2025, (LPA) B. Aborchie arrived at STRTP to initiate the investigation and interviewed, a client and the facility manager (FM). Additionally, LPA interviewed staff 1 (S1), staff 2 (S2). LPA was unable to interview County Social Worker (CSW). SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Babatunde Aborchie LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, MAIN ST., SUITE FACILITY NAME: BELOVED ONES 12FACILITY NUMBER: VISIT DATE: 10/22/2025

met_with: Jonathan Bethel


summary: Facility Evaluation

narrative: On August 20. 2024, Licensing Program Analyst (LPA) Babatunde Aborchie and Licensing Program Manager (LPM) Abdoulaye Traore met with applicant Thandi Smith for component II. LPA and LPM went over revisions needed for the application prior to licensure. Applicant is applying for STRTP license. LPA and LPM gave a copy of the LIC 184, Notice of Incomplete Application, and additional correspondence to assist with the revisions needed to the application. Copy of this report was provided to applicant.


summary: Facility Evaluation

narrative: On September 20. 2024, Licensing Program Analyst (LPA) Babatunde Aborchie and Licensing Program Manager (LPM) Abdoulaye Traore reviewed corrections made by applicant Thandi Smith during the component II. LPA and LPM went over revisions of the corrections made prior to licensure. Applicant is applying for STRTP license. Copy of this report was provided to applicant.


summary: Facility Evaluation

raw_content:
Narrative:
On October 3, 2024, Licensing Program Analyst (LPA) Babatunde Aborchie and Licensing Program Manager Abdoulaye Traore began a pre-licensing inspection for a Short Term Residential Therapeutic (STRTP) license. LPA and LPM met with applicant Thandi Smith, Philip Cook and Salih Robinson who led a tour of the home. The facility was toured both inside and out with the director, Thandi Smith. The applicant is applying to serve six ambulatory clients and non-minor dependents children (NMD). The residence is a five-bedroom two story-house with three bathrooms. The downstairs area consists of a living room, a kitchen, dining area, laundry room, a storage down the stairs, a bathroom, the garage, and the backyard. One room was observed to be the Therapy room. Upstairs consists of 4 bedrooms and two bathrooms. The 3 bedrooms will be utilized for clients, they consist of two twin-size beds in each room, and they will sleep two clients per room. In addition to the upstairs bedrooms, the master bedroom will be utilized for staff office to store clients' file, cleaning supplies and sharp objects. Outside the bedrooms, there was a large loft with a furniture, a television and two computer desks. Bedrooms were arranged so that no more than two clients share a room, and there was one child per bed. No room commonly used for other purposes was used as a bedroom, and no bedroom serves as a passageway to another room. There were adequate drawers and closet space for children's belongings. There were towels and linens stored in downstairs' cabinet. The smoke detectors and carbon monoxides were checked and were working properly. Telephone service and appliances were in a working order. All hazardous items have been properly made inaccessible to areas where clients would have access. The medications and sharp objects/knives will be locked and stored in a storage box in the storage room. Cleansers/chemicals were locked and stored in the laundry room. The first aid kit was in the kitchen cabinet in area by the pantry, accessible and contained all required items. There were no guns or weapons as stated by applicant at this time. The hot water temperature was not tested due to the gas line being shutoff. There was adequate food storage supply of two days of perishable foods and a week of non-perishable food. Proper storage of all food was discussed. Trash cans for storage of solid waste have tight fitting lids. The Facility Sketch, Emergency Disaster Plan, visitation policy and Personal Rights were posted. There were no pool or other body of water and the backyard where clients will have access to play was completely fenced and free of hazards. Based on this inspection of the home, the facility will need the following correction: • The water temperature needs to measure between 105-120 degrees. After the correction is completed, the applicant will notify LPA so that another inspection can be completed. Exit interview was conducted and a copy of this report was provided the administrator Thandi Smith.


summary: Facility Evaluation

raw_content:
Narrative:
On October 7, 2024, Licensing Program Analyst (LPA) Babatunde Aborchie began the continuation of a pre-licensing inspection for a Short Term Residential Therapeutic Program (STRTP) license. LPA met with the operations manager Salih Robinson. LPA conducted a test of the water temperature, and the temperature was measured to be 111 degrees. Currently, the facility is appropriate for a capacity of six ambulatory clients, ages seven to seventeen and non-minor dependents. All requirements were met at this time. Licensing Program Manager will complete a final review prior to issuing a provisional license. Exit interview was conducted and a copy of this report was provided the administrator Salih Robinson.


summary: Facility Evaluation

raw_content:
Narrative:
On March 27, 2025, Licensing Program Analyst (LPA) Babatunde Aborchie began a post-licensing inspection for Beloved Ones Short Term Residential Therapeutic (STRTP). LPA met with, Philip Cook, Salih Robinson and Jonathan Bethel who led a tour of the home. The facility was toured initially with Phillip Cook, Salih Robinson and Jonathan Bethel took over when Phillip Cook's attention was needed by a client in care. The tour was conducted both inside and out. The facility currently has 3 clients in care. The facility was licensed to serve six ambulatory clients and non-minor dependents children (NMD). The residence is a five bedroom two story house with three bathrooms. The downstairs area consists of a living room, a kitchen, dining area, laundry room, a storage down the stairs, a bathroom, the garage, and the backyard. One room was observed to be used as an office. Upstairs consists of 4 bedrooms and two bathrooms. The 3 bedrooms used for clients, they consist of one twin bed in room 2, two twin-size beds in room 4 and 5, they sleep one client per room currently. In addition to the upstairs bedrooms, the master bedroom was used for staff office to store clients' file, and sharp objects. Outside the bedrooms, there was a large loft with furniture, a television and two computer desks for clients. Bedrooms were arranged so that no more than two clients share a room, and there was one child per bed. No room commonly used for other purposes was used as a bedroom, and no bedroom serves as a passageway to another room. There were adequate drawers and closet space for children's belongings. There were towels and linens stored in downstairs' cabinet. The smoke detectors and carbon monoxides were checked and were working properly. Telephone service and appliances were in a working order. All hazardous items have been properly made inaccessible to areas where clients would have access. The medications and sharp objects/knives were locked and stored in a storage box in the storage room. Cleansers/chemicals were locked and stored in the laundry room. The first aid kit was in the kitchen cabinet in area by the pantry, accessible and contained all required items. There were no guns or weapons as stated by the facility manager at this time. The hot water temperature was tested to be 109 degrees. There was adequate food storage supply of two days of perishable foods and a week of non-perishable food. Proper storage of all food was discussed. Trash cans for storage of solid waste have tight fitting lids. The Facility Sketch, Emergency Disaster Plan, visitation policy and Personal Rights were posted. There were no pool or other body of water and the backyard where clients will have access to play was completely fenced and free of hazards. LPA interviewed three of two clients present and two staff. Based on this post-licensing inspection of the home, no deficiencies were found during this inspection. An exit interview was conducted, a copy of this report was provided to facility manager, Phillip Cook.

met_with: Phillip Cook


summary: Facility Evaluation

raw_content:
Narrative:
On August 5, 2025, at 2: PM, Licensing Program Analyst (LPA) Jessica Peete met with Beloved Ones Short Term Residential Therapeutic Program (STRTP), Facility Manager Shaun Dwyer to assess an Enhanced Civil Penalty (ECP). On May 23, 2025, LPA Peete delivered a Complaint Investigation Report to the STRTP. The allegations that a Minor (FC1) sustained a broken arm while in care and facility staff (S1) do not treat a minor (FC1) with dignity and respect were substantiated. The investigation provided sufficient evidence that S1 physically assaulted FC1, resulting in FC1 sustaining a broken arm. The STRTP was cited from the Interim Licensing Standards(ILS) Personal Rights (c)(16), which states (c) The licensee shall ensure that each child, regardless of whether the child is in foster care, is accorded the personal rights... (16) To be free of physical, sexual, emotional, or other abuse, and from corporal or unusual punishment, exploitation, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature ... Based on an analysis of confidential interviews and documentation, the Department has determined that an ECP is warranted for the facility not ensuring FC1's personal rights were protected, as a result, FC1 was subjected to physical abuse by S1, which resulted in serious bodily injury. Penal Code section 243 defines serious bodily injury as a serious impairment of physical condition, including, but not limited to, the following: loss of consciousness; concussion; bone fracture... Therefore, pursuant to the Enhanced Civil Penalty Law, Health, and Safety Code 1548(f)(1)(C), the Department will be issuing an immediate Civil Penalty of $2,500.00. (Continued on LIC 809C) An exit interview was completed, and appeal rights were discussed. A copy of this report, the Confidential Names List LIC 811, and the Civil Penalty Assessment-Serious Bodily Injury/Sexual Abuse (Form 421-D) were provided to the Facility Manager Shaun Dwyer. The signed copy will be retained in the facility file.

met_with: Facility Manager Shaun Dwyer


facility_name: BELOVED ONES 14

summary: Facility Evaluation

raw_content:
Narrative:
On December 15, 2025, Licensing Program Analyst (LPA) Babatunde Aborchie began a pre-licensing inspection for a Short Term Residential Therapeutic Program (STRTP) license. LPA met with administrator, Philip Cook and operations manager, Salih Robinson who led a tour of the home. The facility was toured both inside and out with the applicants. Currently there is no child placed in the home. The applicant is applying to serve two minor and nonminor dependents children (NMD). The residence is a four-bedroom single-story-house with two bathrooms. The area consists of a living room, a kitchen, dining area, storage, two bathrooms, the garage, laundry area and the backyard. There were four bedrooms in total. Bedroom #1 consists of one twin-size bed; it will sleep one client. Vacant. Bedroom #2 will be utilized for one client; it consists of one twin-size bed; it will sleep one client. Bedroom #3 consists of office furniture; it will be used as an office, to store medications and files. Bedroom #4 was vacant; it will be used as a study room. Bedrooms were arranged so that no more than two clients share a room, and there was one child per bed. No room commonly used for other purposes was used as a bedroom, and no bedroom serves as a passageway to another room. There were adequate drawers and closet space for children's belongings. Towels and linens were stored in a cabinet by the clients' bedrooms. The smoke detectors and carbon monoxides were checked and were working properly. The fireplace was in the living room area, and it was properly screened. All appliances were in working order. All hazardous items have been properly made inaccessible to areas where clients would have access. The medications and sharp objects/knives will be locked and stored in a storage box in the office closet. Cleansers/chemicals were locked and stored in the hallway closet. The first aid kit was in a cabinet in the office, accessible and contained all required items. There were no guns or weapons as stated by applicant at this time. The hot water temperature was tested and noted to be 113 degrees. There was adequate food storage supply of two days of perishable foods and a week of non-perishable food. Proper storage of all food was discussed. Trash cans for storage of solid waste have tight fitting lids. The Facility Sketch, Emergency Disaster Plan, visitation policy and Personal Rights were posted. There was no pool or other body of water and the backyard where clients will have access to play was completely fenced and free of hazards. Currently, the facility is appropriate for a capacity of two ambulatory clients, ages seven to seventeen and non-minor dependents. All requirements were met at this time. Licensing Program Manager will complete a final review prior to issuing a provisional license. Exit interview was conducted and a copy of this report was provided to the administrator, Philip Cook and operations manager, Salih Robinson.

met_with: Administrator