304200146-9-6-2023-06-CC-DVSA-CVEP3G-20230906105732

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304200146
Report Date: 09/06/2023
Date Signed: 09/06/2023 10:57:38 AM

Document Has Been Signed on 09/06/2023 10:57 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	BILLEH, LUSI, SAMIR, & VICTORIA		FACILITY NUMBER:	304200146
ADMINISTRATOR:	BILLEH, LUSI		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(714) 974-5734
CITY:	ORANGE	STATE: CA	ZIP CODE:	92865
CAPACITY:	14	CENSUS: 2	DATE:	09/06/2023
TYPE OF VISIT:	Case Management - Deficiencies	UNANNOUNCED	TIME BEGAN:	10:33 AM
MET WITH:	Licensee, Samir Billeh		TIME COMPLETED:	11:15 AM

NARRATIVE

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In conjunction with another inspection at the facility, Licensing Program Analyst (LPA) Dianna Valdez Santana conducted a case management inspection.

LPA was met by licensee, Samir Billeh who provided a tour of the facility. Co-licensee, Lucy Billeh was not present due to a doctor visit. LPA observed 2 children in care, also present was licensee's assistant and their son.

A review of staff records on this date indicates that all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions.

On 5/17/23, the Regional Office (RO) received a call from Orange Police Department stating a child in home accessed a firearm and injured themselves.

Through the file review, the Regional Office had no knowledge or record of weapons at the facility. On the 3 past annual inspections (11/3/2005, 2/9/2018, 3/6/2019) licensee stated there are no weapons/firearms in the facility. On another past 4 annual inspection (4/11/1994, 12/4/1995, 4/2/2007, 4/6/2009), the licensing reports indicated “Guns/Firearms in Facility – No”. In addition, while Licensee was being interviewed on 06/06/23, Licensee disclosed to a Department representative that there are three safes in the home, one safe was Licensee’s and her husband’s and the two other safes belonged to her son, Yousef Billeh. Licensee stated the second safe is where their son keeps his firearms and the other smaller safe is where he kept ammunition separately. Licensee’s son Yusef disclosed to the Department representative that he started purchasing firearms since 2005. Licensee failed to disclose to the RO that there were weapons in the facility.

Based on the gathered information, the facility is in violation and being cited for one Type A 1596.885(c) H&S- Conduct Inimical This is an immediate health and safety and personal rights risk to the children in care. See deficiency observed and cited on LIC 809D.

LPA Valdez Santana informed Licensee, Samir Billeh that this report dated 09/06/23 documents one Type A citation which shall be posted for 30 consecutive days as there are immediate risks to the health, safety, or personal rights of children in care.

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Dianna ValdezSantana	TELEPHONE: 714-292-8628
LICENSING EVALUATOR SIGNATURE:	DATE: 09/06/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: BILLEH, LUSI, SAMIR, & VICTORIA	FACILITY NUMBER: 304200146
	VISIT DATE: 09/06/2023

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Also, LPA Valdez Santana informed the Licensee to provide a copy of this licensing report dated 09/06/23 that documents any Type A citations to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Exit interview was conducted. The Notice of Site Visit was posted. Appeal Rights was explained. A copy of appeal rights (LIC 9058 1/16) was provided and their signatures on this form acknowledges receipt of these rights. First level appeal is to Regional Manager, address is above on the report.

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Dianna ValdezSantana	TELEPHONE: 714-292-8628
LICENSING EVALUATOR SIGNATURE:	DATE: 09/06/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 09/06/2023 10:57 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: BILLEH, LUSI, SAMIR, & VICTORIA	FACILITY NUMBER: 304200146
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/06/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 09/08/2023 Section Cited HSC 1596.885(c)	1 2 3 4 5 6 7	1596.885(c)H&S- Conduct Inimical - conduct which is inimical to the health, morals, welfare, or safety of either an individual in or receiving services from the facility or the people of this state. This requirement is not met as evidenced by:	1 2 3 4 5 6 7	Licensee stated they will give the LIC 9224 form parents and a copy of the report. They will email LPA Valdez Santana their POC plan by due at dianna.valdezsantana@dss.ca.gov
	8 9 10 11 12 13 14	Based on the file review, the Regional Office (RO) had no knowledge or record of weapons at the facility. Licensee failed to disclose to the RO there are weapons at the facility. This poses an immediate risk to the children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Dianna ValdezSantana	TELEPHONE: 714-292-8628
LICENSING EVALUATOR SIGNATURE:	DATE: 09/06/2023

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2023

LIC809 (FAS) - (06/04)

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