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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005787
Report Date: 08/19/2025
Date Signed: 08/19/2025 03:19:42 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/15/2025 and conducted by Evaluator Alvaro Ramirez Jr.
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20250515161202

FACILITY NAME:A MISSION FOR MICHAELFACILITY NUMBER:
306005787
ADMINISTRATOR:CHRISTINA KAYANANFACILITY TYPE:
772
ADDRESS:33721 BLUE LANTERNTELEPHONE:
(949) 371-3857
CITY:DANA POINTSTATE: CAZIP CODE:
92629
CAPACITY:6CENSUS: 6DATE:
08/19/2025
UNANNOUNCEDTIME BEGAN:
09:07 AM
MET WITH:Brittany Garcia-Client Coordinator, Kasey Muise-Residential Supervisor, Kerri Bamper-Compliance AssociateTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Facility did not complete treatment reviews per program plan
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. conducted an unannounced visit to deliver findings on the above allegation received on May 15, 2025. LPA was greeted and granted entry into the facility and met with Client Coordinator Brittany Garcia. LPA explained the reason for the visit. Residential Supervisor Kasey Muise arrived shortly after.

This Department has investigated the complaint alleging facility did not complete treatment reviews per program plan. Regarding the allegation the following was revealed: During the course of the investigation LPA reviewed the Master Treatment Plan dated April 23, 2025, for Client 1 (C1). Per Master Treatment Plan the original Master Treatment Plan was created on April 1, 2025. Per Master Treatment Plan the Master Treatment Plan was reviewed on April 23, 2025, approximately three weeks after it was created. LPA reviewed documents including the A Mission for Michael Program Description. Per Program Description under Evaluating Client Progress it states treatment plan review to be conducted bi-weekly.
CONTINUED 9099-C...
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.
LICENSING EVALUATOR SIGNATURE:

DATE: 08/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 22-AS-20250515161202
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: A MISSION FOR MICHAEL
FACILITY NUMBER: 306005787
VISIT DATE: 08/19/2025
NARRATIVE
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Based on observations and the interviews which were conducted, the preponderance of evidence standard has been met, therefore the following allegation: Facility did not complete treatment reviews per program plan is deemed SUBSTANTIATED. California Code of Regulations, Title 22, Division 6, Chapter 8 is being cited on the attached LIC 9099D.

An exit interview was conducted with Residential Supervisor Kasey Muise and a copy of this report along with the Appeal Rights were provided at the time of this visit.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.
LICENSING EVALUATOR SIGNATURE:

DATE: 08/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 22-AS-20250515161202
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: A MISSION FOR MICHAEL
FACILITY NUMBER: 306005787
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/19/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/22/2025
Section Cited
CCR
81022(a)(j)
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81022 Plan of Operation (a)(j) The facility shall operate in accordance with the terms specified in the plan of operation and may be cited for not doing so. This requirement was not met as evidence by: Based on observations and interviews the facility conducted a Master Treatment Plan review
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Licensee to read regulation and sign a statement of understanding. Licensee to email LPA POC by POC due date.
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three weeks after it was created instead of bi-weekly as stated on the facility Program Description. This poses a potential health, safety or personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.
LICENSING EVALUATOR SIGNATURE:

DATE: 08/19/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5