facility_name: GRACEFUL HEARTS

raw_content:
Narrative:
Regarding the allegation that foster parents yell at minors in care and do not treat minors with dignity and respect, it was specifically reported that foster parents yelled and screamed at the foster children in care, to the extent that spit came out of the foster parent's mouth. Confidential interviews provided conflicting information. Some confidential interviews disclosed that foster parents did not yell at foster children, while other interviews disclosed that foster parents yelled often. A confidential interview reported that FC1 had a video recording of foster parents yelling at foster children. However, despite multiple requests, LPA was not provided with any video evidence. Regarding the allegation that foster parents are not providing minors while in their bedrooms, it was specifically reported that foster parents open the door to the foster children's bedrooms without asking while they are changing. During investigation, a confidential interview disclosed that when foster children lock themselves in bedroom, foster parents would knock on bedroom door and ask foster children to open the door but after not getting a response, foster parents would enter foster children's bedroom to ensure that foster children were safe. However, confidential interviews disclosed that foster parents would enter FC1's and FC2's bedroom without permission. Another confidential interview disclosed that one-time, the foster father entered FC1's bedroom without permission while FC1 was changing then left the door open afterwards. LPA received conflicting information. Based on confidential interviews, the allegations that foster parents yell at FC1, FC2 and FC3 in care; foster Parents do not treat minors with dignity and respect; and foster parents are not providing privacy to FC1 while in their bedrooms may have occurred, however, there was not a preponderance of evidence to support the alleged violations, therefore, these allegations are unsubstantiated at this time An exit interview was conducted and a copy of this report along with the appeal rights were explained and provided to Licensee, Hannah Daba.

Investigation Findings:
13On 10/01/2025, at 10:30AM, Licensing Program Analyst (LPA) Maya Chavez conducted an unannounced visit to Graceful Hearts Small Family Home (SFH) and met with Licensee, Hannah Daba to deliver investigative findings for the allegations listed above involving licensees/foster parents and foster children (FC1, FC2, and FC3) as listed on the Confidential Names List (LIC 811). On 08/08/2025, Community Care Licensing (CCL) received a complaint that foster parents yell at minors in care, foster parents do not treat minors with dignity and respect, and foster parents are not providing minors while in their bedrooms. On 08/14/2025, LPA M. Chavez conducted a health and safety inspection at the SFH, and no immediate health and safety hazards were observed. In addition, LPA obtained documents pertinent to the investigation and interviewed licensee/foster parents (LS/ FFs), foster children (FC1 and FC2). LPA was unable to interview FC3 due to FC3's developmental age. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Maya 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 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: GRACEFUL HEARTSFACILITY NUMBER: VISIT DATE: 10/01/2025

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

met_with: Licensee, Hannah Daba


state: CA

summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
Regarding the allegation that staff threatened a minor, it was specifically disclosed that FC1 repeats words, experiences, and sounds. Furthermore, it was specifically disclosed that as of recently FC1 has been repeating a new script during lunch time: "eat your food or I'll hurt you". During investigation, a confidential interview disclosed that FC1 has been saying new scripts during lunch such as the following: "If you don't finish, your food I'm going to hurt you" and at another point, "if you don't stop now, I'm going to hurt you" which is concerning. Confidential interview disclosed that it's hard to tell whether FC1 is scripting something from the past or current. In addition, a confidential interview disclosed that FC1 repeats scripts that FC1 has heard outside of the home and that FC1 can hear something once then will repeat it at random times. Other confidential interviews disclosed that FC1 eating habits were never a concern and there would be no reason to ever use threats to have FC1 finish meals. Furthermore, additional confidential interviews disclosed that the only scripts LS and FF repeated to FC1 had to do with asking FC1 to do something then telling FC1 if they do what they are asked then LS and FF will take FC1 to Walmart. Confidential interviews disclosed two separate occurrences where it's possible LS or FF hurt/hit FC1, but it was only heard and not observed. LPA received conflicting information. Based on confidential interviews, the allegation that the licensee or foster father threatened FC1 may have occurred, however, there was not a preponderance of evidence to support the alleged violation, therefore, this allegation is unsubstantiated at this time An exit interview was conducted, appeal rights explained, and a copy of this report was provided to Licensee, Hannah Daba.

Investigation Findings:
13On 10/01/2025, at 10:30AM, Licensing Program Analyst (LPA) Maya Chavez conducted an unannounced visit to Graceful Hearts Small Family Home (SFH) and met with Licensee, Hannah Daba to deliver the investigative finding for the allegation listed above involving licensees and foster children (FC1, FC2, and FC3) as listed on the Confidential Names List (LIC 811). On 09/04/2025, Community Care Licensing (CCL) received a complaint that staff threatened minors. On 09/05/2025, LPA M. Chavez conducted a health and safety inspection at the SFH, and no immediate health and safety hazards were observed. In addition, LPA obtained documents pertinent to the investigation and interviewed licensee and foster father (LS and FF), foster children (FC2 and FC3), County Social Workers (CSWs), and a confidential witness at FC1's school. LPA was unable to interview FC1 due to FC1's developmental age. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Maya 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 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: GRACEFUL HEARTSFACILITY NUMBER: VISIT DATE: 10/01/2025

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

report_type: Complaint Investigation

complaint_status: unsubstantiated


summary: Facility Evaluation

raw_content:
Narrative:
On January 21, Licensing Program Analyst (LPA) Maryjane Perez met with applicant Hannah Daba this date for a Component II. LPA went over revisions needed for the application prior to licensure. LPA gave a copy of the LIC 184, Notice of Application Revision, and additional correspondence to assist with the revisions needed to the application. A copy of this report was provided to applicant Hannah Daba.

report_type: Facility Evaluation

met_with: Applicant- Hannah Daba


summary: Facility Evaluation

raw_content:
Narrative:
On February 6, 2025 at 1: PM Licensing Program Analyst (LPA) Maryjane Perez arrived at Graceful Hearts Small family Home for a pre-licensing inspection for an initial license. LPA met with applicant Hannah Daba who led a tour of the entire home inside and out. Currently there are no children placed in the home. The applicant is applying to serve four children ages 6 to 17. The home is a two-story building with four bedrooms and 3 bathrooms. The downstairs consists of an entry way with visitation log, living room #1 fully furnished with couches and television, a kitchen with fully stocked pantry and refrigerator that has perishable and nonperishable foods. The kitchen also has a drawer with locked sharps/ knives and a locked sink cabinet storing cleaning supplies. There is a dining table with adequate seating as well as living room #2 that is fully furnished and has locked cabinet space for clients files and medication. Bathroom #1 is located downstairs with water temperature reaching 112.1 degrees. There is a hallway that has facility sketch, personal rights, disaster plan, weekly activity schedule and visitation policy posted. The garage was spacious and free of hazards with a work out section for age appropriate clients to use. The stair way consists of a closet for coats and jackets and a fire extinguisher that is up to date. The upstairs consists of a hallway with a desk and book shelves with books and activities. There is a laundry room that stores detergent and cleaning supplies in a locked cabinet. Bedroom #1 is also upstairs and will be utilized by two clients and has two twin size beds, dresser and closet space that is currently vacant. Bedroom #2 will be utilized by two clients and has two twin size beds with adequate drawer and closet space that is also currently vacant. Bedroom #3 is occupied for applicants biological son that will be locked at all times. There is a linen/ towel closet, bathroom #2 that is fully functioning, as well as bedroom #4 that is the master bedroom for applicant that has bathroom #3 which is also fully functioning. Bedrooms were arranged so that no more than two children share a room, and there was one child per bed. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There was adequate drawer and closet space for children's belongings. The smoke detectors and carbon monoxide detectors were checked, and they were working properly. Telephone service and appliances were in working order. All hazardous items have been properly made inaccessible to areas where clients/children will have access. First Aid kit was accessible with all required items. As stated by applicant, there were no weapons/firearms and there were no pools or other bodies of water. The backyard where children will have access to play was completely fenced and free of hazards. There are no corrections needed at this time. Based on this inspection, the home is appropriate for a capacity of 4 ambulatory clients. The request for licensure will be forwarded to Licensing Program Manager for final approval. Component III orientation was also completed this day of Feburary 6, 2025. An exit interview was conducted. A copy of this report was provided to applicant Hannah Daba.

visit_type: Prelicensing


summary: Facility Evaluation

raw_content:
Narrative:
On July 23, 2025, Licensing Program Analysts (LPAs) Maryjane Perez and Cynthia Ramos arrived at Graceful Hearts Small Family Home (SFH) for a post-licensing inspection. LPA's met with licensee Hannah Daba who led a tour of the home inside and out. Currently there is three children placed in the home. Licensee was approved to served four ambulatory clients ages 6-17 years old. The home is a two story building with four bedroom and three bathrooms. The downstairs consists of an entry way with visitation log, living room #1 fully furnished with couches and television, a kitchen with fully stocked pantry and refrigerator that stored a locked box for medication and has perishable and nonperishable foods. The kitchen also has a drawer with locked sharps/ knives and a locked sink cabinet storing cleaning supplies. There is a dining table with adequate seating as well as living room #2 that is fully furnished and had a locked cabinet for client/ personnel files and medication. Bathroom #1 is located downstairs. There is a hallway that has facility sketch, personal rights, and weekly activity schedule. The stairway consists of a closet for coats/ jackets and a fire extinguisher that is up to date. The upstairs consists of a hallway with a desk and book shelves with books and activities. There is a laundry room that stores detergent and cleaning supplies in a locked cabinet. Bedroom #1 is also upstairs and was utilized by two clients and has two twin size beds, dresser/ closet space and all required bedding. Bedroom #2 was utilized by one client and has two twin size beds with adequate drawer and closet space. Bedroom #3 was occupied by licensees biological son that was locked at all times. There was a hallway closet storing linen/ towel, bathroom #2 that had water measuring 122.5 degrees Fahrenheit. Licensee understands that the water temperature needs to measure between 105-120 degrees F. Bedroom #4 was the master bedroom for licensee that has bathroom #3 which was fully functioning. The garage was spacious with a work out section for age appropriate clients to use and was locked at all times. The backyard where children will have access to play was completely fenced and free of hazards and there were no pools or other bodies of water. Bedrooms were arranged so that no more than two children share a room, and there was one child per bed. No room commonly used for other purposes is used as a bedroom, and no bedroom serves as a passageway to another room. There was adequate drawer and closet space for children's belongings. The smoke detectors and carbon monoxide detectors were checked, and they were working properly. Telephone service and appliances were in working order. All hazardous items have been properly made inaccessible to areas where clients/children will have access. First Aid kit was accessible with all required items. As stated by licensee, there were no weapons/firearms in the home. Three client files and three personnel files were reviewed as well as one staff, two residents, and one client were interviewed. An exit interview was conducted and a copy of this report and three technical assistances were discussed and provided to licensee Hannah Daba.

met_with: Licensee- Hannah Daba


facility_name: GRIFFIN CAREGIVING

summary: Facility Evaluation

raw_content:
Narrative:
On October 1, 2025 at 9: AM, LPA Timika Martin conducted a Component II meeting at the Monterey Park Children's Residential Program office with Small Family Home applicant, Lenetta Griffin. The purpose of the meeting was to review and discuss the facility's application and plan of operation, and to assess the applicant's understanding of the regulations in place for a Small Family Home. LPA confirmed that all application documents requested for revisions have been received and reviewed. No further revisions to the application documents are needed. LPA discussed the need for the applicant's designee to be fingerprinted. LPA discussed the following sections of the facility's Plan of Operation with the applicant: · Purpose/Goals/Program Method · Description of Basic Services · Procedures for Handling Medical/Dental Care · Description on how to handle Medical Emergencies · Procedure for handling and Assisting Children with Self-Administration of Medications · Transportation Arrangements · Procedures for immediate response to incidents and complaints · Complaints and Grievance · Discipline Policies · Visitor/Provisions for Contact with parents/Placement Representatives ·Ground for Dismissal/Relocation/Removal from Placement · Admission Policies · Sample Menu · Run-away Plan/Emergency Intervention · Procedures for Handling/Monitoring Children's Funds, Personal Inventory, Clothing · Disaster Preparedness · Staff Training LPA Martin instructed Applicant to submit corrections and/or revisions to the appropriate sections of the plan of operation as discussed, via email on or before October 15, 2025. An exit interview was conducted, and a copy of this report was provided to Ms. Griffin.

met_with: Lenetta Griffin


summary: Facility Evaluation

raw_content:
Narrative:
On December 11, 2025 at 10: AM, Licensing Program Analyst (LPA) Timika Martin conducted a pre-licensing inspection visit at Griffin Caregiving. LPA Martin met with Facility Administrator, Lenetta Griffin and toured the home. Physical Plant This facility is located in a quiet residential community. The facility consists of five (5) bedrooms, three (3) bathrooms, kitchen, dining area, laundry room in a 2--car garage, and a backyard. Overall, the facility is clean, sanitary and in excellent condition. Passageways are free from obstruction. Fixtures, Furniture, Equipment, and Supplies The home has toilets and wash basins for clients' use. Client bedrooms was observed to be clean, orderly, and contained full sized beds. LPA observed clean pillows, bed sheets and blankets. The client's bedroom has adequate closet and drawer space to accommodate client's clothing and personal belongings. Heath Related Services and Record Keeping The first aid kit will be centrally stored in the kitchen. The kit contains all required supplies. The client, staff files will be in a locked file cabinet located upstairs in the office area. The medication will be stored in a locked cabinet in the kitchen. LPA Martin will conduct a final review once the requested documents are submitted, manager approval and all requirements being met and a new license will be mailed to SFH upon approval. An exit interview was conducted, and a copy of this form was emailed to the Administrator.


facility_name: GROWING TOGETHER

summary: Facility Evaluation

raw_content:
Narrative:
On April 16, 2025, Licensing Program Analyst (LPA) Lucero Jauregui and Licensing Program Manager (LPM) Dawn Segura met with applicant Leslie Peabody to conduct a Component II face-to-face interview. LPA and applicant discussed the application process and documents submitted as part of the application. LPA and applicant discussed needed revisions to the application and program statement prior to today's meeting. At this time, updates and revisions have been received by Community Care Licensing. LPA advised applicant that she will proceed with conducting Component III and the pre-licensing visit. A copy of this report was provided to applicant.

met_with: Applicant Leslie Peabody


summary: Facility Evaluation

raw_content:
Narrative:
On April 16, 2025 at 10: AM, Licensing Program Analysts (LPA's) Lucero Jauregui and Lisa Bernabe conducted a pre licensing inspection and component III orientation. LPA's met with applicant Leslie Peabody. The applicant is applying for a Small Family Home with the capacity of 3 ambulatory clients, ages 3- 17 years old. The facility is a two story home. The first floor consists of a garage, one bedroom/den, bathroom, one master bedroom, dinning room, great room, kitchen, coffee bar and patio area. Bedroom/den is occupied by the applicants biological son. The master bedroom consists of two beds, and an open plan bathroom which consist of a bathtub, shower room, bathroom, and closet space. Master bedroom is occupied by applicants biological daughter and one additional bed to occupy one client. The great room is a shared space with a tutoring area and a treadmill. Per applicant, garage will remain locked at all times. The hot water temperature was measured in the downstairs bathroom measuring 119.1 degrees farenheit. The kitchen was observed to be clean and pantry with non-perishable items. LPA's observed Emergency Disaster Plan, Ombudsman Personal Rights and facility sketch posted. Medication is maintained locked in a medicine box in a kitchen cabinet. A first aid kit was available with all required items. Chemicals are maintained locked in a cabinet under the kitchen sick. Sharps were observed to be kept in a kitchen cabinet. The second floor consists of a loft, master bedroom, two bedrooms (bedroom #2 and bedroom #3), laundry room, and a bathroom. The master bedroom is occupied by the applicant. Bedroom #3 can occupy 2 clients. Bedroom #2 is occupied by applicants biological son and one additional bed to occupy one client. Continued... The loft will be used as a play room and lounge area. LPA's observed video games and board games for client use. The homes outdoor patio space has a gazebo, table, chairs and a blackstone. LPA's observed the patio to be free from observable hazards. LPA's observed a total of 8 cameras inside the home. There are 2 cameras in the lounge area,1 in the upstairs hallway, 1 in the stair way, 1 in the entry of the home, 2 in the great room, and 1 in the coffee bar. Per applicant, there are no firearms in the home. Based on this inspection, the facility will need update their program statement for the requirements and considerations for video camera usage. The applicant will be notified once the final review of application has been completed and all requirements of Title 22, Division 6, of the California Code of Regulation have been met. An exit interview was conducted and a copy of this report was given to applicant Leslie Peabody.

met_with: Leslie Peabody, Applicant


raw_content:
Narrative:
During the investigation, LPA observed a bar cabinet in S1's bedroom. LPA received a photo of a wine carton on what appeared to be the counter of the facility; however, there was no way of determining when the photo was taken or whether there was anything in the carton at the time. Based on confidential interviews and a lack of verifiable evidence, the allegation that staff did not prevent minors from having access to alcohol is unsubstantiated. The allegation may have happened or may be valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted, and a copy of this signed report and appeal rights were provided to Leslie Peabody.

Investigation Findings:
13On March 20, 2026 at 10: AM, Licensing Program Analyst (LPA) Lucero Jauregui arrived at the facility unannounced and met with Licensee Leslie Peabody to discuss the investigative finding for the allegation noted above. LPA Jauregui conducted an inspection of the facility on January 22, 2026, and no immediate deficiencies were noted. During the investigation, LPA Jauregui interviewed one staff (S1) and one client (C1). On January 15, 2026, Community Care Licensing (CCL) received allegation that staff did not prevent minors from having access to alcohol. It was reported that S1 went out for the night and left wine out and accessible on the kitchen counter. Confidential interview indicated alcohol is stored out of reach of children. Confidential interview indicated that alcohol is maintained locked in S1's bedroom. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Dawn Segura LICENSING EVALUATOR NAME: LUCERO JAUREGUI LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 08-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SAN DIEGO RO, METROPOLITAN DR. # FACILITY NAME: GROWING TOGETHERFACILITY NUMBER: VISIT DATE: 03/20/2026

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

met_with: Leslie Peabody, Licensee


facility_name: GUARDIAN ANGELS

summary: Facility Evaluation

raw_content:
Narrative:
On December 16, 2024, at 1: PM, a Component II Office Visit was held to discuss the application received for Guardian Angels Small Family Home located at Debut Place Valencia, CA 91381. Attending Component II were the following individuals: Nieman Johnson, Applicant, Aimee Moratalla, Licensing Program Analyst, and JoAunne Griffin, Licensing Program Manager. The purpose of this Component II meeting was to review and discuss the incomplete application and Program Statement and to resolve any outstanding concerns that may have existed. The following incomplete application forms were discussed at the meeting: 1. Application for a Community Care Facility or Residential Care Facility for the Elderly License (LIC 200). 2. Applicant Information (LIC 215) 3. Affidavit Regarding Client/resident Cash Resources (LIC 400) 4. Surety Bond (LIC 402) 5. Budget Information (LIC 420) 6. Personnel Report (LIC 500) 7. Personnel Record (LIC 501) 8. Health Screening (LIC 503) 9. Criminal Record Clearance (LIC 508D) 10. Emergency Disaster Plan (LIC C) 11. Fire Inspection 12. Program Statement 13. Basic Services 14. Organizational Information 15. First/Aid card/certificate The Applicant was advised of the following revision and/or corrections needed to the application and/or Program Statement. Revisions are due January 2, 2025. Email revisions to Aimee.Moratalla@dss.ca.gov. Fire inspection was completed December 16, 2024, and denied and follow up with fire inspector will be completed. The Pre-Licensing inspection has been scheduled January 16, 2025 at AM. A copy of this report was provided to the Applicant Nieman Johnson.

met_with: Neiman Johnson


summary: Facility Evaluation

raw_content:
Narrative:
On February 24, 2025, at 10: AM Licensing Program Analyst (LPA) Erika Butler, and Licensing Program Manager (LPM) JoAunne' Griffin arrived at Guardian Angels for the purpose of conducting a Pre-Licensing Inspection. LPA and LPM met with Applicant, Nieman Johnson who granted access to the home and together a tour of the interior and exterior home was conducted. Currently living in the home is the Applicant. The home is set up as follows: This is a four bedroom, two and half bathroom home located in a residential area. The home consists of a living room, kitchen, laundry space (upstairs), backyard area, and garage. Living room: is equipped with mounted television, sectional couch, shoe cabinet, and bear bricks. Dining room: Applicant purchased a dining room table and it will be delivered, February 25, 2025. Kitchen: is equipped with a refrigerator/freezer, a six burner gas stove (all burners were operational at the time of the inspection), and microwave. Sharp knives are kept inaccessible in Applicant's bedroom which will be locked. LPA observed a covered trash can, dishes, and eating utensils. LPA observed ample perishable and non-perishable food items. Applicant will ensure that three nutritious meals and snacks will be provided to the clients. Bedroom #1: clients bedroom (upstairs) is equipped with twin size beds, adequate closet space, television, adequate lighting, and windows. 809 continued on page Bedroom #2: Applicant's bedroom (upstairs) is equipped with a queen size bed, television, adequate closet and dresser space, adequate lighting, and windows. Bedroom #3: client's bedroom (upstairs) is equipped with a full size bed, adequate closet and dresser space, television, adequate lighting, and windows. Bedroom #4: client's bedroom (upstairs) is equipped with a twin size bed, adequate closet and dresser space, television, adequate lighting, and windows. Bathroom: Bathroom #1 is located in Applicant's bedroom upstairs, bathroom #2 is located in the hallway upstairs, and half bathroom #3 is located near the front door entrance. Vehicle: The Applicant will use a Tesla Model X to transport clients. Insurance is valid from September 2024 - February 2025. The vehicle was observed to be in good condition. The home's temperature is maintained by central air/heating. LPA observed two fully charged fire extinguishers which are located in the entrance to the home and living room area. Extra linens will be stored in clients bedroom. All other towels/linen are to be kept in the Applicant's bedroom. The smoke alarm and carbon monoxide detectors were tested and found to be in working order. First Aid kit was found to be complete with required items. Disinfectants and cleaning solutions are kept in a locked cabinet in Applicant's bedroom. Report continued on LIC 809C. (Page 2 of 3) LPA reminded Applicant to ensure the following when clients are in placement: Children are accorded personal rights and the corresponding form is in their file. Children are supported and encouraged to participate in extracurricular activities. Children are allowed and encouraged to contact the licensing agency, in confidence, without threats or punishment for making complaints. Children are accorded dignity in personal relationships with others in the home. Applicant acknowledges abuse reporting requirements. Applicant will ensure grievance process, Disaster Plan, discipline policies and procedures will be posted in dining room area. During the inspection, LPA reiterated the importance of submitting Special Incident Reports and reporting all changes within the facility to Community Care Licensing and any other appropriate agency. The Applicant will purchase a dinning room table, extra linen/towels, a cell phone to be used by clients in care, applicant will email a copy of the First Aid/CPR and to LPA Butler. At the time of the visit LPA Butler received a copy of the Applicant's Driver License and original copy of the Surety Bond. Licensee needs to be associated to Guardian. LPA informed Applicant that a Component III meeting will be held February 27, 2025 at PM. An exit interview was conducted and copy of report will be emailed to Applicant, Nieman Johnson.

met_with: Nieman Johnson


summary: Facility Evaluation

raw_content:
Narrative:
On February 27, 2025, at 1: PM, Licensing Program Analyst (LPA), Erika Butler, LPA, Aimee Moratalla, and Licensing Program Manager (LPM), JoAunne Griffin conducted a Small Family Home (SFH) Component III virtual meeting with Applicant, Nieman Johnson. LPA Butler, LPA Moratalla, and LPM Griffin met with Applicant to discuss forms required to be maintained, available, and posted at the facility for inspections. We discussed child and personnel records that are required to be documented, retained and available for inspection. We further discussed specific requirements, concerns and issues operating a SFH, such as, reporting requirements, personnel requirements, supervision, intake issues, compatibility, removal/discharge policies, complaint procedures, transportation, health services, food, hygiene, visitation, personal property, searches, and community sensitivity. LPA Moratalla will submit the application for licensure effective . A copy of this report will be emailed to the Applicant.


summary: Facility Evaluation

raw_content:
Narrative:
On September 5, 2025, at 09: AM Licensing Program Analyst (LPA) Miguel Gomez arrived at Guardian Angels for the purpose of conducting a Post-Licensing Inspection. LPA Gomez met with Licensee, Nieman Johnson who granted access to the home and together a tour of the interior and exterior home was conducted. There is one client living in the home. The home is set up as follows: This is a four bedroom, two and half bathroom home located in a residential area. The home consists of a living room, kitchen, laundry space (upstairs), backyard area, and garage. Living room: is equipped with mounted television, sectional couch, and shoe cabinet. Dining room: dining room table for six (6) Kitchen: is equipped with a refrigerator/freezer, a six burner gas stove (all burners were operational at the time of the inspection), and microwave. Sharp knives are kept inaccessible in Licensee's bedroom which will be locked. LPA observed a covered trash can, dishes, and eating utensils. LPA observed sample perishable and non-perishable food items. Bedroom #1: Vacant (upstairs) is equipped with twin size beds, adequate closet space, television, adequate lighting, and windows. 809 continued on page Bedroom #2: Client 1 (C1)bedroom (upstairs) is equipped with two twin beds, adequate closet and dresser space, television, adequate lighting, and windows Bedroom #3: (Vacant) is equipped with a single twin size bed, adequate closet and dresser space, television, adequate lighting, and windows. Bedroom #4: Licensee's bedroom (upstairs) is equipped with a queen size bed, television, adequate closet and dresser space, adequate lighting, and windows. Bathroom: Bathroom #1 is located in Licensee's bedroom upstairs, bathroom #2 is located in the hallway upstairs, and half bathroom #3 is located near the front door entrance. Vehicle: Licensee will use a Tesla Model X to transport clients. The vehicle is insured by USAA. The home's temperature is maintained by central air/heating. LPA Gomez observed two fully charged fire extinguishers which are located in the entrance to the home and living room area. Extra linens are stored in the laundry room and towels in clients bathroom. The smoke alarm and carbon monoxide detectors were tested and found to be in working order. First Aid kit was found to be complete with required items. Disinfectants and cleaning solutions are kept in a locked cabinet in Licensee's bedroom. An exit interview was conducted and copy of report will be emailed to Licensee, Nieman Johnson.


summary: Facility Evaluation

raw_content:
Narrative:
On 02/27/2026 at 09: AM Licensing Program Analyst (LPA) Miguel Gomez arrived at the facility for the purpose of conducting an annual inspection. LPA Gomez met with Licensee Nieman Johnson, who granted access to the home. The home is set up as follows: This is a four bedroom, two and half bathroom home located in a residential area. The home consists of a living room, kitchen, laundry space (upstairs), backyard area, and garage. Living room: is equipped with mounted television, sectional couch, shoe cabinet, and bear bricks. Dining room: Applicant purchased a dining room table and it will be delivered, February 25, 2025. Kitchen: is equipped with a refrigerator/freezer, a six burner gas stove (all burners were operational at the time of the inspection), and microwave. Sharp knives are kept inaccessible in Applicant's bedroom which will be locked. LPA observed a covered trash can, dishes, and eating utensils. LPA observed ample perishable and non-perishable food items. Bedroom #1: clients bedroom (upstairs) is equipped with twin size beds, adequate closet space, television, adequate lighting, and windows. 809 continued on page Bedroom #2: Applicant's bedroom (upstairs) is equipped with a queen size bed,futon, television, adequate closet and dresser space, adequate lighting, and windows. Bedroom #3: client's bedroom (upstairs) is equipped with a full size bed, adequate closet and dresser space, television, adequate lighting, and windows. Bedroom #4: client's bedroom (upstairs) is equipped with a twin size bed, adequate closet and dresser space, television, adequate lighting, and windows. Bathroom: Bathroom #1 is located in Applicant's bedroom upstairs, bathroom #2 is located in the hallway upstairs, and half bathroom #3 is located near the front door entrance. The home's temperature is maintained by central air/heating. LPA observed two fully charged fire extinguishers which are located in the entrance to the home and living room area.The smoke alarm and carbon monoxide detectors were tested and found to be in working order. Disinfectants and cleaning solutions are kept in a locked cabinet in Applicant's bedroom. Licensee stated that he no longer wants to continue with the license.LPA Gomez requested for a copy of the license and a letter resignation. An exit interview was conducted and copy of report will be provided to Licensee, Nieman Johnson.

visit_type: Annual


facility_name: GUILLEN'S FAMILY, THE

summary: Complaint Investigation - Unsubstantiated

raw_content:
Narrative:
On October 28, 2021, the Department received an allegation that C1 was in the home had sustained multiple injuries including broken bones while in care. More specifically, C1 sustained a broken nose, contusions to the back of the head, bruising, a black eye and other injuries. Confidential interviews revealed that C1 has sustained injuries in the small family home and while at school, due to C1's medical condition. C1 has fallen down and hit the back of C1's head due to his medical condition on a couple of occasions. Confidential interviews and records reviewed did not indicate that C1 had broken C1's nose. There were no specific dates of when the injuries occurred and no witnesses to the allegation. Based on confidential interviews the allegation that C1 in the home has sustained multiple injuries including broken bones while in care may or may not have occurred, however, the allegation is not supported or proven by the evidence gathered. Therefore, the allegation is determined to be unsubstantiated. No deficiencies were cited. An exit interview was conducted and a copy of this report and appeal rights were provided to Licensee Guillen.

Investigation Findings:
13On June 9, 2022 at 1: PM, Licensing Program Analyst (LPA) Gloria Meza-Gonzalez conducted an unannounced complaint inspection at the above facility. LPA Meza-Gonzalez met with Licensee Rosa Guillen. The purpose of the inspection was to deliver the findings of the complaint investigation. The investigation was conducted by Special Investigator (SI) Nikki Vo from Community Care Licensing (CCL) Investigative Branch. SI Vo interviewed Regional Center Service Coordinator, Licensee, Biological Father, Probate Court Investigator, School Teacher, and School nurse. Staff # 1 and Staff #2 were not available to be interviewed. Client #1 was not able to be interviewed (see confidential name list, LIC811, dated: June 9, 2022). In addition, the following records were reviewed by SI Vo: incident reports, individual program plan, face sheet, residential admission agreement, personal rights, medication log, communication log, and photos of the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Gloria Meza-Gonzalez LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 08-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, METROPOLITAN DR. # FACILITY NAME: GUILLEN'S FAMILY, THEFACILITY NUMBER: VISIT DATE: 06/09/2022

met_with: Rosa Guillen


raw_content:
Narrative:
On March 11, 2022, the Department received allegations that C1 is left in soiled diapers for an extended period of time, the staff does not ensure C1 is sent to school with water/drink supplements, C1's hygiene is not being met, and C1's wheelchair is in disrepair. Confidential interviews revealed that staff changes C1's diaper when C1 gets up in the morning and it's documented in the communication log for the SFH. Additional interviews revealed that staff checks and changes C1's diaper prior to being put on the school bus. Confidential interviews revealed inconsistency as to whether C1 arrives at school in a soiled diaper. Confidential interviews revealed staff packs two supplement drinks and a water bottle container. Confidential interviews revealed inconsistency on whether the licensee fails to provide supplement drinks or a water container for C1. Confidential interviews revealed that C1 is bathed every night and dressed in clean clothes. Staff changes C1 clothes in the morning as well as diapers prior to eating breakfast. Staff brushes C1's teeth prior to being out on the school bus as it is logged in the communication log. Confidential interviews revealed inconsistencies as to whether C1 is bathed every day as C1 has arrived at school with body odor. Confidential interviews revealed that C1's wheelchair was serviced on February 14, 2022. Additional interviews revealed inconsistency as to whether the C1's wheelchair has a missing part. Based on confidential interviews and documentation allegations that C1 is left in soiled diapers for an extended period of time, the staff does not ensure C1 is sent to school with water/drink supplements, C1's hygiene is not being met, and C1's wheelchair is in disrepair may or may not have occurred, however, the allegation is not supported or proven by the evidence gathered. Therefore, the allegation is determined to be unsubstantiated. No deficiencies were cited. An exit interview was conducted and a copy of this report and appeal rights were given to DCS Del Real Valdez .

Investigation Findings:
13On December 9, 2022, at 9: AM, Licensing Program Analyst (LPA) Gloria Meza-Gonzalez conducted an unannounced complaint inspection at the above facility. LPA Meza-Gonzalez met with Direct Care Staff (DCS) Yvette Del Real Valdez . The purpose of the inspection was to deliver the findings of the complaint investigation. LPA Meza-Gonzalez conducted a safety check on March 18, 2022, and no deficiencies were found. During the investigation, LPA Meza-Gonzalez interviewed a staff (S1), Licensee, two County Social Workers (CSW1, CSW2), a Behavior Technician (BT), and two School Personnel (SP1, SP2). LPA Meza-Gonzalez was not able to interview any clients (C1, C2, C3, and C4) (see confidential name list, LIC811, dated December 9, 2022) due to cognitive abilities. LPA Meza-Gonzalez reviewed the wheelchair work order, need and service plan, communication log for the small family home, and communication log for school. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Gloria Meza-Gonzalez LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 08-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, METROPOLITAN DR. # FACILITY NAME: GUILLEN'S FAMILY, THEFACILITY NUMBER: VISIT DATE: 12/09/2022

met_with: Yvette Del Real Valdez


summary: Complaint Investigation - Unsubstantiated - 3 allegations

raw_content:
Narrative:
Based on confidential interviews, the allegation that S1 did not pick up C1 from school in a timely manner and S1 altered C1's doctor's medical note may have occurred, however is not supported, or proven by evidence. Therefore, the allegation is unsubstantiated. An exit interview was conducted, and a copy of this signed report was provided to Andrea Gachuzo & Rosy Guillen.

Investigation Findings:
13On October 5, 2023, at 8: AM, Licensing Program Analyst (LPA) Lucero Jauregui arrived at the facility unannounced and met with Andrea Gachuzo & Rosy Guillen to discuss the investigative findings for the allegations noted above. LPA Jauregui conducted an inspection of the facility on June 26, 2023, and no deficiencies were noted. During the investigation, LPA Jauregui interviewed one staff (S1), obtained C1's ISP, appointment summary for 6/20/23, doctors summary visit 6/20/23, house communication log, school communication log and completed wheel chair orders. On June 21, 2023, the department received an allegation that staff did not pick up child from school in a timely manner and staff altered child's doctor's medical note. LPA received conflicting statements of time it took to have C1 picked up from school. LPA observed C1's electronic medical note not to be altered, however there was handwriting on the top of the note by S1. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: LUCERO JAUREGUI LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 08-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SO. Cal Sc/res, Metropolitan Dr. # FACILITY NAME: GUILLEN'S FAMILY, THEFACILITY NUMBER: VISIT DATE: 10/05/2023

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

met_with: Andrea Gachuzo & Rosy Guillen, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On 09/29/2021 at 8: AM, Licensing Program Analysts (LPA) Gloria Meza-Gonzalez conducted unannounced inspection to the facility. The purpose of the inspection is to conducted an annual required inspection. LPA Meza-Gonzalez met with Licensee Rosa Guillen. The facility serves five ambulatory and non-ambulatory development disabled clients. There are four clients in care. LPA Meza-Gonzalez reviewed four clients' files (see confidential list, dated: 09/29/21) and three staff files. The files appeared to be complete and in order. LPA Meza-Gonzalez three staff. LPA Meza-Gonzalez was not able to interview four clients due to clients' capabilities. Due to time constraints, the annual inspection is being extended for physical plant. Based on observations made during the inspection, no deficiencies observed during today's visit. An exit interview was conducted, a copy of this report and LIC811 was given to Licensee Guillen.


summary: Facility Evaluation

raw_content:
Narrative:
On 10/4/2021 at 11: AM, Licensing Program Analyst (LPA) Gloria Meza-Gonzalez conducted an unannounced required annual inspection. LPA Meza-Gonzalez met with Licensee Rosa Guillen. The home serves developmentally disabled children ages 0-17-year-old ambulatory and non-ambulatory, four ambulatory and one non-ambulatory. There are currently four clients in the home. LPA Meza-Gonzalez toured the Small Family Home (SFH) with Licensee Guillen. LPA Meza-Gonzalez inspected both indoor and outdoor areas of the home. The home is a two-story home with five bedroom and three bathrooms. The first floor is set up as follows: living room, dining room, kitchen, family room, bathroom, a bedroom, laundry room, and garage/playroom. The second floor is set up as follows: master bedroom, master bathroom, two bedrooms, a bathroom, and office/den. Bedroom #1 is reserved for one non-ambulatory client. The bedroom has one twin bed. Bedroom #2 has two twin beds, one bed per client. Bedroom #3 has a computer desk, computer, printer, TV, one twin bed and a small sofa. No client uses this room. Bedroom #4 has two twin beds, one bed per client. Bedroom #5 is the master bedroom and master bathroom is used the by Licensee Guillen. Each bedroom has adequate dresser/night stands, storage and closet space and each bed has clean bedding and mattress pad. Extra linen is stored in a hallway cabinet. The water temperature measured at 120 degree Fahrenheit which is within Community Care Licensing regulation of 105 degrees Fahrenheit to 120 degrees Fahrenheit. The garage is used a playroom for the clients with foam floors, a play set, disable swing, two couches, TV, toys, games and books. See page LIC 809C Toxins are locked up in a cabinet the garage. The medications and knives are locked up in a kitchen cabinet. LPA Meza-Gonzalez observed the kitchen is stock with two days perishable and seven days non-perishable foods. The menu is posted on the refrigerator. There are seven smoke detector and two carbon monoxide in the home. There are two smoke detector downstairs and five upstairs. The smoke detectors were tested and is working properly throughout the home. There are two carbon monoxide detectors located downstairs, one in the kitchen and one in the garage. The carbon monoxide were tested and are working properly. There are two fire extinguisher, one located downstairs in the laundry room and the second located upstairs by the hallway cabinet. The last fire drill was held on 9/6/21. LPA Meza-Gonzalez observed an in-ground pool equipped with an approved pool cover that manually making it inaccessible to children. Licensee Guillen walked across the pool over. The locking devices for the pool cover are functioning properly. The pool is not used by the clients in the home. The pool cover meets Title 22 regulations. The home is operating within the capacity and limitation of the licensee. The home is clean, safe sanitary and in good repair. Per Licensee there are no weapons or firearms in the home at this time. The facility has demonstrated compliance with Title 22, Division 6 of the California Code of Regulation. An exit interview was conducted with the licensee and a copy of this report was given to the Licensee, Rosa Guillen.

visit_type: Case Management


summary: Facility Evaluation

raw_content:
Narrative:
On October 14, 2022, at 08: AM, Licensing Program Analyst (LPA) Gloria Meza-Gonzalez conducted an unannounced inspection. LPA Meza-Gonzalez met with Licensee Rosa Guillen. The purpose of the inspection is to conduct an annual required inspection. The home serves developmentally disabled children ages 0-17-year-old ambulatory and non-ambulatory, four ambulatory and one non-ambulatory. There are currently three clients in the home. LPA Meza-Gonzalez toured the Small Family Home (SFH) with Licensee Guillen. LPA Meza-Gonzalez inspected both indoor and outdoor areas of the home. The home is a two-story home with five bedrooms and three bathrooms. The first floor is set up as follows: living room, dining room, kitchen, family room, bathroom, bedroom, laundry room, and garage/playroom. The second floor is set up as follows: master bedroom, master bathroom, two bedrooms, a bathroom, and office/den/spare bedroom. Bedroom #1 is reserved for one non-ambulatory client. The bedroom has one twin bed. Bedroom #2 has two twin beds, one bed per client. Bedroom #3 has a computer desk, computer, printer, TV, one twin bed, and a small sofa. No client uses this room. Bedroom #4 has two twin beds, one bed per client. Bedroom #5 is the master bedroom and the master bathroom is used by Licensee Guillen. Each bedroom has adequate dresser/nightstands, storage, and closet space, and each bed has clean bedding and mattress pad. Extra linen is stored in a hallway cabinet. The water temperature was measured at 115 degrees Fahrenheit which is within Community Care Licensing regulation of 105 degrees Fahrenheit to 120 degrees Fahrenheit. The garage is used as a playroom for the clients with foam floors, a play set, a disabled swing, two couches, a TV, toys, games, and books. See LIC 809D page Toxins are locked up in a cabinet in the garage. The medications and knives are locked up in a kitchen cabinet. LPA Meza-Gonzalez observed the kitchen is stocked with two days of perishable and seven days of non-perishable foods. The menu is posted on the refrigerator. There are seven smoke detectors and two carbon monoxide in the home. There are two smoke detectors downstairs and five upstairs. The smoke detectors were tested and are working properly throughout the home. There are two carbon monoxide detectors located downstairs, one in the kitchen and one in the garage. The carbon monoxide was tested and is working properly. There are two fire extinguishers, one located downstairs in the laundry room and the second located upstairs by the hallway cabinet. The last fire drill was held on September 1, 2022. LPA Meza-Gonzalez observed an in-ground pool equipped with an approved pool cover that manually made it inaccessible to children. Licensee Guillen walked across the pool over. The locking devices for the pool cover are functioning properly. The pool is not used by the clients in the home. The pool cover meets Title 22 regulations. The home is operating within the capacity and limitation of the licensee. The home is clean, safe sanitary and in good repair. Per Licensee, there are no weapons or firearms in the home at this time. LPA Meza-Gonzalez reviewed three clients (see confidential list, dated: October 14, 2022) and eight staff files. The files appeared to be complete and in order. LPA Meza-Gonzalez interviewed one staff. LPA Meza-Gonzalez was not able to interview any clients due to the clients' capabilities. The facility has demonstrated compliance with Title 22, Division 6 of the California Code of Regulation. An exit interview was conducted with the licensee and a copy of this report was given to the Licensee Guillen


summary: Facility Evaluation

raw_content:
Narrative:
On October 24, 2023 at 9: AM, Licensing Program Analyst (LPA) Lucero Jauregui and Licensing Program Manager (LPM) Ann Valenzuela conducted unannounced inspection to the facility. The purpose of the inspection is to conducted an annual required inspection. LPA and LPM met with Rosa Guillen and Andrea Gachuzo who provided LPA and LPM with a tour. The facility serves three ambulatory and one non-ambulatory development disabled clients. There are two clients in care. The home is a two-story home with five bedrooms and three bathrooms. The first floor is set up as follows: living room, dining room, kitchen, family room, bathroom, bedroom, laundry room, and garage/playroom. The second floor is set up as follows: master bedroom, master bathroom, two bedrooms, a bathroom, and office/den/spare bedroom. Bedroom #1 is reserved for one non-ambulatory client. The bedroom has one twin bed. Bedroom #2 has two twin beds, one bed per client. Bedroom #3 has a computer desk, computer, printer, TV, one twin bed, and a small sofa. Bedroom #4 has two twin beds, one bed per client. Bedroom #5 is the master bedroom and the master bathroom is used by Licensee Guillen. Each bedroom has adequate dresser/nightstands, storage, and closet space, and each bed has clean bedding and mattress pad. The water temperature was measured higher than 120 and adjusted by licensee to 120 degrees Fahrenheit. The garage is used as a playroom for the clients with foam floors, a play set, a disabled swing, two couches, a TV, toys, games, and books. Cleaning chemicals and tools are locked up in a cabinet in the garage. Continued.... The medications and knives are locked up in a kitchen cabinet. The kitchen was observed to be stocked with two days of perishable and seven days of non-perishable foods. Meal menu was observed to be posted in kitchen. There are seven smoke detectors and two carbon monoxide in the home. There are two smoke detectors downstairs and five upstairs. The smoke detectors were tested and are working properly throughout the home. There are two carbon monoxide detectors located downstairs, one in the kitchen and one in the garage. The carbon monoxide was tested and is working properly. There are two fire extinguishers, one located downstairs in the laundry room and the second located upstairs by the hallway cabinet. The last fire drill was held on October 1, 2023. LPA and LPM observed an in-ground pool equipped with an approved pool cover that manually made it inaccessible to children. The locking devices for the pool cover are functioning properly. The pool is not used by the clients in the home. The pool cover meets Title 22 regulations. The home is operating within the capacity and limitation of the licensee. The home is clean, safe sanitary and in good repair. Per Licensee, there are no weapons or firearms in the home at this time. LPA reviewed two client (see confidential list, dated: October 24, 2023) and five staff files. The files appeared to be complete and in order. LPA Jauregui interviewed two staff. LPA was unable to interview clients due to them being non- verbal. The facility has demonstrated compliance with Title 22, Division 6 of the California Code of Regulation. An exit interview was conducted with the licensee and a copy of this report was given to the Licensee Guillen.


facility_name: GYPSUM CREEK SMALL FAMILY HOME

summary: Facility Evaluation

raw_content:
Narrative:
On April 22, 2021 at 9: AM, Licensing Program Analyst (LPA) Abdoulaye Traore began a pre-licensing inspection for a Small Family Home license. Gypsum Creek Small Family Home was previously licensed and has relocated to the above address for a new license. LPAs met with applicant Lenetta Hutchings who led a tour of the home. The facility was toured both inside and out with the applicant. Currently there was one developmentally child placed in the home. The applicant is applying to serve two developmentally disabled children ages 3 to 18 including non-minor dependent (NMD) The home is in a community gated homes accessible by gate code that changes every month. The residence is 4 a bedroom and 3 bath home which is set up as follow: Downstairs: It consists of a living room, a kitchen, dining area, storage down the stairs, a bathroom, the garage and the patio/backyard. Upstairs: · Bedroom # The master bedroom, it had a queen-size bed and sleeps licensee's/applicant. · Bedroom #2 had a twin-size bed. It was vacant. It will one foster child. · Bedroom #3 had a twin-size bed. It sleeps 1 foster child. · Bedroom #4 it had a king-size bed and it sleeps licensee's 37-year-old son. · A laundry room, A loft, and two bathrooms. Bedrooms are arranged so that no more than two children share a room, and there is one child per bed. 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. Upstairs outside the bedrooms, there was a loft designated game and play area which contained toys and books. It was observed to be safe, clean, and age appropriate for the age group of children to be cared for. The smoke detectors 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 children will have access. The medications and sharp objects/knives were locked and stored in a storage/closet under the stairs. Cleansers/chemicals were locked and stored in the laundry room. The first aid kit was located in a cabinet in the kitchen area by the garage door. 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. First Aid kit was accessible and contained all required items. 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 children will have access to play was completely fenced and free of hazards. In accordance with Title 22, Division 6, Chapters 1 & 4 and based on this relocation pre-licensing inspection, the home is appropriate for a capacity of 2 ambulatory developmentally disabled children ages 3-18 years. Licensee/applicant stated that she is willing to continue providing services for non-minor dependents (NMD). All requirements were met at this time. The request of License will be forwarded to Licensing Program Manager for final approval Exit interview conducted. A copy of this report was provided to the Licensee, Ms. Lenetta Hutchings

met_with: Lenetta Hutchings


summary: Facility Evaluation

raw_content:
Narrative:
On Friday February 24, 2023 at 9: AM Licensing Program Analyst (LPA) Jessica Peete conducted an annual inspection of the facility. At time of inspection LPA met with Licensee Lenetta Hutchings. The facility was toured inside and out with the Licensee. The home is a two story residence with four bedrooms and three bathrooms. Currently there are no clients in placement. Bedrooms are arranged so that there is one client per a room and one client per bed. There is adequate shelf and closet space for client's belongings. Extra linens are stored in the hall closet .The bathrooms were clean and in good repair. The hot water was measured to between 105 -120 degrees Fahrenheit.. All hazardous items have been properly made inaccessible to areas where clients will have access. Sharp knives are locked in the living room closet, inaccessible to clients, medications will be stored in the same place. Cleansers and chemicals are locked and stored in laundry room closet. The first aid kit is in the kitchen cabinet and contained all required supplies. The facility's smoke and carbon monoxide detectors operable and hard wired into the facility. Fire extinguishers are properly charged and serviced; they located in the garage and kitchen. There are no guns or weapons in the facility as stated by Licensee Lenetta Hutchings. LPA observed a minimum 7-day non-perishable and a 2-day perishable supply of food. There was a variety of snacks available for clients as well. The following required posted items were observed accessible to clients: Grievance Procedures, Personal Rights, Visitation policies. The menu was not posted as the licensee, does not currently have clients. The facilities outside grounds were also inspected and found to be clean, well maintained, and free of observable hazards. There are no pools or other bodies of water on the property. There is adequate indoor and outdoor activity space; all exits, and walkways were free from obstruction. (Continued on LIC C) Based on observations, from today's visit, no deficiencies are being cited. An exit interview was conducted and a copy of this report and appeal rights were given to Licensee Lenetta Hutchings.

met_with: Licensee Lenetta Hutchings


summary: Facility Evaluation

raw_content:
Narrative:
On June 13th, 2025, at 9: AM Licensing Program Analyst (LPA) Claudia Aguilera arrived at Gypsum Creek Small Family Home (SFH) to conduct an unannounced annual licensing inspection. The Facility was toured both inside and out with Licensee Lenetta Hutchings. The home is a two-story building with four bedrooms and three bathrooms. Upon entry of the home, LPA observed an open concept layout with living room, dining room, restroom, and kitchen. The living room consisted of a couch and television. The dining room consisted of a table with chairs. In addition, two stools were observed to be available in the kitchen island. The kitchen was fully inspected. The first aid kit was also observed to be in a kitchen cabinet and easily accessible to clients. The fire extinguisher was observed to be operable and located in the kitchen. LPA also observed a trash can in the kitchen that contained a tight-fitting cover. All sharps and chemicals are kept locked in a closet located downstairs. Bathroom #1 was also located downstairs; the bathroom was inspected and fully functioning. The garage was also inspected and observed to be utilized for storage and one vehicle. The upstairs consisted of Bedroom #1 occupied by Licensee and always remains locked. Licensee's bedroom also included bathroom #2. Bedroom #2 was consisted of a twin bed and sleeps licensee's legal guardian son. Bedroom #3 is currently vacant with one twin bed, a closet and storage space for future client. Bedroom #4 remains locked and it sleeps licensee's adult son. Bathroom #3 was located upstairs it was inspected and fully functioning. The laundry room was also located in the hallway upstairs a closet is included in the laundry room which remains locked and stores all cleaners and detergents. The water temperature was tested and measured at 120 degrees F. LPA observed a minimum of seven-day non-perishable and a three-day perishable supply of food. All windows and screens were in good repair. The smoke and carbon monoxide detectors were tested and operable. There were no guns or weapons in the home as stated by Licensee. The following required posted items were observed to be accessible: personal rights, visitation policy, and emergency numbers. The backyard was also fully inspected, no hazards or obstructions were observed. Based on today's inspection and observations, there are no deficiencies being cited at this time. An exit interview was conducted, and a copy of this report was provided to Licensee.


facility_name: WEST SMALL FAMILY HOME

raw_content:
Narrative:
Regarding lack of supervision resulting in FC1 leaving the facility, a confidential interview denied lack of supervision resulted in FC1 leaving facility. A confidential interview stated FC1 was checked at 4: AM and FC1 was observed in bed sleeping. A confidential witness stated that RM provided security alarm systems on exit doors. CSW disclosed that FC1 was diagnosed of severe autism and developmentally delayed. FC1 did leave the facility for a short period of time after 4am but was redirected back into the facility. Information obtained from confidential interviews denied that there is lack of supervision and disclosed that FC1 is constantly being supervised. CSW believed there was adequate supervision in the home for FC1 and Small Family Home (SFH) was an appropriate placement for FC1. LPA received inconsistent information regarding FC1 leaving the facility due to lack of care and supervision. Based on confidential interviews, the Department determined there was not sufficient information to determine that lack of supervision resulting in FC1 leaving facility. Although the allegation may have happened or may be valid, there was not a preponderance of evidence to support or deny the allegation. The Department's finding was that this allegation is unsubstantiated. A copy of this report and LIC 811 was reviewed and provided to the Licensee

Investigation Findings:
13On August 18, Licensing Program Analyst (LPA), Babatunde Aborchie arrived at West Small Family Home to deliver investigative findings involving the small family home. LPA met with licensee. On April 22, 2022 at 09: AM, Licensing Program Analysts (LPAs) Babatunde Aborchie and Rafael Enriquez arrived at the small family home to initiate the investigation and conducted interviews with foster mother (FM), and observed three of three foster children (FC1, FC2 and FC3). LPA was unable to interview FC1, FC2 and FC3 due developmental disabilities of being none-verbal. Additionally, On August 16, LPA also interviewed County Social Worker. On April 19, 2022 a complaint report was referred to Community Care Licensing (CCL) alleging Lack of supervision resulting in minor leaving facility UnsubstantiatedEstimated 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: WEST SMALL FAMILY HOMEFACILITY NUMBER: VISIT DATE: 08/18/2022

met_with: Resource Mother


raw_content:
Narrative:
In regards to the allegation that provider/licensee did not provide adequate supervision to FC1 in care, it was specified that a stranger located FC1 barefoot walking down a busy street two blocks away from the home. A confidential interview denied not providing adequate supervision for FC1 in care and added that FC1 was constantly being supervised. The confidential interview continued stating that FC1 was checked at 8: AM and FC1 was observed in bed sleeping. Another confidential interview stated FC1 must have jumped out the upstairs window and walked out the side gate that was opened. CSW indicated that the home had an alert system and door chimes to all the exits. CSW added that FC1 left the facility approximately at 9: AM and the facility was informed by the law enforcement that FC1 was found in the neighborhood bare foot. CSW believed there was adequate supervision in the home for FC1 and the Small Family Home (SFH) was an appropriate placement for FC1. LPA did not receive a consistent information regarding FC1 leaving the facility due inadequate supervision. Based on the confidential interviews, the allegation that facility did not provide adequate supervision to FC1 in care, may have happened or is valid, but there is not a preponderance of evidence to prove that the alleged violation occurred. Therefore, the allegation is unsubstantiated at this time. A copy of this report and LIC 811 was reviewed and provided to the Licensee

Investigation Findings:
13On December 12, Licensing Program Analyst (LPA) Babatunde Aborchie arrived at West Small Family Home to deliver the investigative finding involving the small family home and foster children listed on confidential names (LIC 811). LPA met with Licensee. On June 22, Licensing Program Analysts (LPA) Babatunde Aborchie arrived at the small family home to initiate the investigation and conducted interviews with foster mother (FM), and met with three of three foster children (FC1, FC2 and FC3). LPA was unable to interview FC1, FC2 and FC3 due developmental disabilities. Additionally, LPA also interviewed adult biological child and County Social Worker (CSW) On June 16, 2022 a complaint report was referred to Community Care Licensing (CCL) alleging licensee did not provide adequate supervision to minor in care. UnsubstantiatedEstimated 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: WEST SMALL FAMILY HOMEFACILITY NUMBER: VISIT DATE: 12/12/2022

met_with: Licensee


raw_content:
Narrative:
It was specifically reported that foster mother has been neglectful in taking FC1 to scheduled ophthalmology appointments. However, confidential interviews stated that if foster children doctors' appointments are missed, it is due to unforeseen circumstances such as sickness. LPA could not obtain additional information. Based on confidential interviews and a review of pertinent documents, the allegation that Licensee does not ensure foster children attend their scheduled doctor's appointments 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.

Investigation Findings:
13On 9/11/2024, at 10: AM, Licensing Program Analyst (LPA) Maryjane Perez conducted an unannounced visit to Haalo Innovation, LLC and met with Licensee (LS) Luvly West to deliver the investigative finding for the allegation listed above. On December 20, 2023, LPA Babatunde Aborchie met with LS and conducted a health and safety inspection where no deficiencies were observed. Lpa B. Aborchie also obtained facility and client records. In addition, LPA M. Perez interviewed LS and foster children (FC1, FC2, FC3 and FC4), however, LPA M. Perez was unable to gather information due to FC1, FC2, FC3 and FC4 having limited communication. On December 11, 2023, Community Care Licensing received a complaint allegation that Licensee does not ensure foster children attend their scheduled doctor's appointments. During the investigation confidential interviews reported that when the foster children's doctor appointments are missed, they are rescheduled to doctors' availability and licensee has no control on how long it will take to be seen again. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: MaryJane Perez LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE CRP RO, MAIN ST., SUITE FACILITY NAME: HAALO INNOVATIONS,LLCFACILITY NUMBER: VISIT DATE: 09/11/2024

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

met_with: Licensee Luvly West


raw_content:
Narrative:
Other confidential interviews stated that there were police officers and a social worker who came to the home to look at the foster children and did not find any injuries. LPA was unable to gather additional information. Regarding the allegation that staff does not communicate effectively, It was specifically reported that there have been emails and voice mails left for foster mother regarding the foster children. During investigation, confidential interviews stated that foster mother has not received any emails or voice mails regarding the foster children. Other confidential interviews stated they did not know if foster mother had received any voice mails or emails from the foster children's school. Lpa R. Enriquez was unable to gather additional information as foster children were non-verbal. Based on confidential interviews and a review of pertinent documents, the allegations that FC1 sustained unexplained injury while in care and staff does not communicate effectively may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violations occurred. Therefore, the allegations are unsubstantiated at this time. An exit interview was conducted, and a copy of this report along with the appeal right were provided to administrative manager Candace Collier.

Investigation Findings:
13On December 19, 2024, at 10:20AM Licensing Program Analyst (LPA) Maryjane Perez made an unannounced visit to Haalo Innovations, LLC Small Family Home (SFH) and met with administrative manager Candace Collier to deliver the investigative finding for the allegations listed above. On September 17, 2024, Community Care Licensing received complaint allegations that minor sustained unexplained injury while in care and that staff does not communicate effectively. On September 23, 2024, LPA Rafael Enriquez met with facility manager (FM) and conducted a health and safety inspection, and no deficiencies were observed. Lpa R. Enriquez obtained client roster, employee schedule and other pertinent documents. Lpa R. Enriquez also interviewed LS and staff 1 (S1). In addition, LPA R. Enriquez attempted to interview foster child 1 (FC1), foster child 2 (FC2), foster child 3 (FC3), and foster child 4 (FC4). In regard to the allegation that a minor sustained unexplained injury while in care, confidential interviews reported that there were no bruising or other markings on any of the foster children's bodies. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: MaryJane Perez LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 19-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION RIVERSIDE CRP RO, MAIN ST., SUITE FACILITY NAME: HAALO INNOVATIONS,LLCFACILITY NUMBER: VISIT DATE: 12/19/2024

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

met_with: Administrative manager- Candace Collier


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Narrative:
It was added that the bruises/marks on C1 were not observed before. During the investigation, there were inconsistencies in the information gathered to support whether the bruising on C1 occurred while in care or at the school. In addition, confidential records indicated that the incident was reported to CCL confirming there were no observed incidents or accidents on C1 prior to going to school, therefore, the cause of the bruising remains unknown. Based on confidential interviews and a review of pertinent documents, the allegation that C1 sustained unexplained bruising while in care may have occurred, but there is not a preponderance of the evidence to prove that the alleged violation occurred. Therefore, the allegation is unsubstantiated. An exit interview was conducted and a copy of this report along with the appeal right were provided to Administrative Manager Candance Hornsby.

Investigation Findings:
13On 06/09/2025 at 12:40PM, Licensing Program Analyst (LPA) Claudia Aguilera conducted an unannounced visit at Haalo Innovations LLC Small Family Home (SFH) and met with Administrative Manager Candance Hornsby to deliver the finding for the above stated allegation. On 04/08/2025, Community Care Licensing (CCL) received a complaint allegation that a minor sustained unexplained bruising while in care. On 04/14/2025, LPA M. Perez conducted a health and safety inspection of the facility, and no hazards were observed. Lpa M. Perez also obtained pertinent documents. In addition, LPA C. Aguilera interviewed Licensee, Staff 1, Staff 2, County Social Worker (S1, S2, CSW) and Client 1 (C1) and received copies of Individual Program Plan (IPP) and Special Incident Reports. Regarding the allegation that minor (C1) sustained unexplained bruising while in care. It was specifically alleged that C1 had three purple/yellow bruises on C1's left arm and one on C1's right arm. The bruises were two to three centimeters long. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Abdoulaye Traore LICENSING EVALUATOR NAME: Claudia Aguilera 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: HAALO INNOVATIONS,LLCFACILITY NUMBER: VISIT DATE: 06/09/2025

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

met_with: Administrative Manager Candance Hornsby


summary: Facility Evaluation

raw_content:
Narrative:
On the January 26, 2022 at 10: AM, Licensing Program Analysts (LPAs) Babatunde Aborchie and Charmaine Linley, met with licensee who granted access to the home. The purpose of this visit is to conduct an annual required inspection of the small family home. Presently there is one foster child in placement and one of one was not present during time of inspection (See LIC 811). The home is a two story with six bedrooms and four and a half bathrooms. Bedroom #1 has one queen, a full and one twin beds, it is a guest room. Bedroom #2 has a king size bed, it is occupied by licensee's son Bedroom #3 master bedroom has a king-sized bed: sleeps licensee and the fiancée. Bedroom #4 has two twin beds; it is occupied by a child and an adult in the home. Bedroom #5 has two twin beds; it is occupied by foster child. Bedroom #6 has two twin beds; it is occupied by two other adults living in the home. Bedrooms are arranged so that no more than two children share a room, and there is one child per bed. 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. Individual beds were observed with appropriate clean linens, pillows, comforters, and mattresses in good repair. The fireplace is properly screened. All hazardous items have been properly made inaccessible to areas where children will have access. The medications are locked and stored in a container in the office. Cleansers/chemicals are locked and stored in the laundry room cabinet. Sharp knives are inaccessible and stored in a locked box in the pantry. The first aid kit is in the office. There are no guns or weapons as stated by Licensee at this time.


summary: Facility Evaluation

raw_content:
Narrative:
On the December 6,2023 at 9: AM, Licensing Program Analysts (LPA) Karen Beal, met with licensee, Luvly West who granted access to the home. The purpose of this visit is to conduct annual required inspection of the small family home. Presently there are three foster children in placement and 0 of 3 was not present during time of inspection (See LIC 811). Licensee stated that the children are not able to hold a conversation. The home is a two story with six bedrooms and four and a half bathrooms. Bedroom #1 Twin Beds Bedroom #2 has a king size bed, it is occupied by licensee's son Bedroom #3 master bedroom has a king-sized bed: sleeps licensee and the fiancée. Bedroom #4 has two twin beds; it is occupied by a child and an adult in the home. Bedroom #5 has two twin beds; it is occupied by foster child. Bedroom #6 has two twin beds Bedrooms are arranged so that no more than two children share a room, and there is one child per bed. 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. Individual beds were observed with appropriate clean linens, pillows, comforters, and mattresses in good repair. All hazardous items have been properly made inaccessible to areas where children will have access. Medications were locked in the downstairs closet next to bedroom #1. The fireplace is properly screened. All hazardous items have been properly made inaccessible. The medications are locked and stored in a container in the office. Cleansers/chemicals are locked and stored in the laundry room cabinet. Sharp knives are inaccessible and stored in a locked box in the pantry. The first aid kit is in the office. There are no guns or weapons as stated by Licensee at this time. Cleansers/chemicals were locked and stored in laundry room upstairs. Sharp knives were inaccessible and stored in a locked tool box in the pantry. The home had two first aid kits. One kit was in the medication cabinet with all required items and the other one accessible in the office. Water temperature was tested and was safe. Smoke detectors in all rooms were tested and operable. Proper storage of all food was noted. Trash cans for storage of solid waste had tight fitting lids. The Emergency Disaster Plan, Facility Sketch and Title Personal Rights were posted at this time. The back yard was safe and free of hazards. Games and a computer were located in the loft area upstairs and were age appropriate for the age group of children being cared for. There was no body of water/pool at the home. Three client files were reviewed and four employee files. CPR and First Aid card expires on March 2024. Children and staff records are organized. All staff have received criminal record and child abuse index check clearances. All training was up to date. There is no deficiency observed during today's visit. Exit interview conducted and copies of this report was given to Luvly West.

met_with: Luvly West, Licensse


summary: Facility Evaluation

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Narrative:
On June 3rd, 2025, at 9:43AM Licensing Program Analysts (LPAs) Claudia Aguilera and Cynthia Ramos arrived at Haalo Innovations LLC Small Family Home (SFH) to conduct an unannounced annual licensing inspection. The Facility was toured both inside and out with the Administrative Manager Candance Hornsby. The home is a two-story building with six bedrooms and four and a half bathrooms. During the inspection, LPAs observed upon entry a large office was observed equipped with desks, computers, and chairs. Bedroom #1 which sleeps licensee's adult legal guardian son. The downstairs also consisted of a half bathroom that was inspected and fully functioning. A small hallway closet containing games, coats, and shoes was also observed. The garage was also inspected and contained two freezers and a refrigerator containing food. Additionally, the garage stores snacks, continence supplies, tables, and filing cabinet. The downstairs also consisted of the kitchen with a dining room table with a seating area of 8 chairs. The kitchen island was also observed to provide additional seating. The pantry was also observed to contain sharps/knives in a locked box, medications, and cleaning supplies were kept locked under the kitchen sink. The family room consisted of a large sectional couch, television, covered fireplace, blanket, yoga ball, and a large connect four activity game. The downstairs are included bedroom #2 that always remains locked and sleeps the living facility manager. The upstairs consisted of Bedroom #3 occupied by licensee and always remains locked which also includes bathroom #2. A loft was also observed and contained a couch, television, games, desktop computer and chair. Bedroom #4 sleeps licensee's adult legal guardian daughter which also includes bathroom #3. In the hallway a linen closet was observed and contained blankets, sheets, towels, and a fire extinguisher. Bedroom #5 consisted of two twin beds which are occupied by 16- and 17-year-old male clients. The room contained plenty of storage for clothing and a closet. The laundry room was also inspected and remains locked as it is used for storing cleaning and laundry supplies. Bedroom #6 consisted of two twin beds which are occupied by 15- and 16-year-old male sibling clients, the room had drawers for storage and a closet. Bathroom #4 was fully functioning and observed to have a trashcan with a closed tight lid. The water temperature was tested and measured at 109 degrees F. LPAs observed a minimum of seven-day non-perishable and a three-day perishable supply of food. There was a variety of snacks available for clients as well. The clients' medication log records were kept updated with no discrepancy. Two fire extinguishers were observed and operable. All windows and screens were in good repair. The smoke and carbon monoxide detectors were tested and operable. There were no guns or weapons in the home as stated by Administrative Manager. The following required posted items were observed accessible to clients: personal rights, visitation policy, and current menu. The backyard was also inspected, a shed was observed and fully inspected, no hazards or obstructions were observed. There are seven cameras located in common areas and five outdoor cameras which meet the title 22 camera policy. Based on today's inspection and observations, there are no deficiencies being cited at this time. An exit interview was conducted, a copy of this report was provided to Licensee.


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Narrative:
Regarding the allegation that staff did not treat FC1 with respect, no specific examples were provided to clarify how FC1 was allegedly disrespected. One confidential interview reported that FC1 was always treated respectfully while in care and was unaware of any incidents in which FC1 felt disrespected. Another confidential interview stated they felt disrespected at times but could not specify what actions or behaviors constituted the disrespect; they believed FC1 may have spoken to in a rude manner. Additional interviews indicated that FC1 was consistently treated with respect and was well cared for. LPA received conflicting information. In regard to the allegation that staff spoke inappropriately to residents, it was reported that staff verbally abused FC1 with statement such as, "You're nothing, you will never get a job, you will never be anything". One confidential interview denied ever speaking to FC1 in an abusive manner and stated that staff were always mindful of how they addressed FC1 and other residents. Another confidential interview did not recall the specific statements made to FC1 but expressed dissatisfaction with the manner in which FC1 had been spoken to. An additional confidential interview reported never hearing anyone speak to FC1 in a rude or inappropriate way and stated that staff consistently provided encouragement to help FC1 thrive. Regarding the allegation that S1 hit FC1, it was specifically reported that S1 would strike FC1 with open or closed hand; however, details provided were unclear. During investigations, one confidential interview stated that S1 would not hit a child and described the relationship with FC1 as cordial while FC1 was in care. Another confidential interview was unsure which part of FC1's body S1 had contacted. An additional confidential interview stated that staff are well trained and would not hit any client. Another confidential interview indicated that they had never heard of or received any reports of staff hitting FC1 or any other foster child. Regarding the allegation staff handles FC1 in a rough manner, a confidential interview stated FC1 was not handled in a rough manner. The confidential interview stated that FC1 was always given the freedom in and around the home. Another confidential interview stated FC1 was forcefully dragged into the car during an outing. Confidential interview added the incident happened one time. Additional confidential interview could not recall observing FC1 being handled roughly. Confidential interview added that there was a cordial relationship between staff and FC1. Based on the confidential interviews, the allegation that staff do not treat FC1 with respect, staff spoke inappropriately to FC1, staff hit FC1, staff handles FC1 in a rough manner, may have happened or valid, but there is not a preponderance of evidence to prove that the alleged violations occurred. Therefore, the allegations are unsubstantiated at this time. A copy of this report and LIC 811 was reviewed and provided to the Licensee

Investigation Findings:
13On December 3, 2025, Licensing Program Analyst (LPA) Babatunde Aborchie arrived at HAALO Innovations LLC Small Family Home and met with licensee to deliver the finding regarding the above stated allegations involving the home and foster children listed on confidential names (LIC 811). On March 14, 2025, a complaint report referred to Community Care Licensing (CCL) alleging that staff do not treat residents with respect, staff spoke inappropriately to residents, staff hit a resident, staff handles resident in a rough manner. On April 2, 2025, Licensing Program Analyst (LPA) MaryJane Perez arrived at the small family home to initiate the investigation and conducted interviews with foster mother (FM), facility manager (FM), staff 1, staff 2 (S1, S2) and Therapist (TH). Lpa B. Aborchie met with three of three foster children (FC1, FC2 and FC3). LPA was unable to interview FC1, FC2 and FC3 due to their limited verbal communication. Additionally, LPA was unable to interview County Social Worker (CSW). UnsubstantiatedEstimated 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: HAALO INNOVATIONS,LLCFACILITY NUMBER: VISIT DATE: 12/03/2025


summary: Facility Evaluation

raw_content:
Narrative:
On April 8th, Licensing Program Analyst (LPA) Cynthia Ramos arrived at Haalo Innovations LLC Small Family Home (SFH) to conduct an 2 year required inspection. The facility was toured both inside and out with the Licensee Luvly West. The home is a two-story home with six bedrooms and four and a half bathrooms. The downstairs consisted of kitchen, large living room area with covered fireplace, dining table, office and half bathroom and hallway closet. Bedroom #1 was occupied by licensee's adult legal guardian son. Bedroom #2 was occupied by licensee's adult son and always remains locked. The garage was also inspected and contained two freezers and a refrigerator with additional food. The knives, medications and cleaning supplies were locked in a cabinet in the pantry. The upstairs consisted of a loft that consisted of a large sofa and gaming devices. Bedroom #3 was occupied by Licensee and always remains locked. Bedroom #4 sleeps licensee's adult legal guardian daughter. Bedroom #5 consisted of two twin beds that were occupied by 18 year old and 17 year old male clients. Bedroom #6 consisted of two twin beds which were occupied by 16-year-old and 15-year-old male clients. All client bedrooms were observed to have adequate bedding and adequate closet space. The laundry room was also inspected and remains locked as it is used for storing cleaning and laundry supplies. All restrooms in the home were observed to have a trashcans with a closed tight lid and working properly. In the hallway a linen closet was observed and contained blankets, sheets, towels, and a fire extinguisher. The water temperature was tested and measured at 116.1 degrees F. LPA observed a minimum of seven-day non-perishable and a three-day perishable supply of food. Two fire extinguishers were observed and operable. The smoke and carbon monoxide detectors were tested and operable. Per Licensee, there were no guns or weapons in the home at this time. The following required posted items were observed accessible to clients: personal rights, visitation policy, and current menu. The backyard was also inspected, a shed was observed and fully inspected, no hazards or obstructions were observed. There are eight cameras located in common areas and seven outdoor cameras in the home which meet the title 22 camera policy. Based on today's inspection, there are no deficiencies being cited at this time. An exit interview was conducted and a copy of this report was provided to Licensee Luvly West.

met_with: Licensee, Luvly West


facility_name: HACKETT HAVEN

raw_content:
Narrative:
An exit interview was conducted, appeal rights discussed and a copy of this report was left with Ronald Hackett, Facility Manager whose signature on this form confirms receipt.

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

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: Ronald Hackett, Facility Manager


raw_content:
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: Melynda Hackett, Licensee


summary: Facility Evaluation

raw_content:
Narrative:
On May 8, 2024 at 9:15am, Licensing Program Analyst (LPA) Monica Pavia conducted an announced pre-licensing inspection of the home. LPA met and toured the home with Licensee, Melynda Hackett, Licensee, LaVonne Spencer, and facility staff, Ronald Hackett Jr. This Small Family Home (SFH) is a two story home located in a residential area. The home consists of 2 client bedrooms and 2 client bathrooms, living and dining areas, and kitchen. The home is clean, safe, sanitary, and in good repair. All passageways are unobstructed and all doors open freely. There is no pool on the premises. Fire arms are not allowed on the home premises. At the time of visit, the following was observed: Fire extinguishers are throughout the house. Smoke detectors/carbon monoxide detectors are throughout the house and operational. Each bedroom has a bed, clean linens, and adequate drawer/cabinet space. First aid kit was observed. Staff and client records will be stored and locked on site. Medications will be centrally stored and locked on site. Disinfectants and other toxic materials will be locked in the garage. Extra bedding and towels are kept in the hallway cabinet. Knives and sharps will be kept locked in the kitchen. The upstairs client bedroom closet door will be repaired or replaced. LPA Pavia will be sending letter requesting a few Facility Program updates and a follow-up home inspection will be scheduled.

met_with: Melynda Hackett