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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306006294
Report Date: 08/12/2025
Date Signed: 08/12/2025 03:42:50 PM

Unsubstantiated


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
05/16/2025 and conducted by Evaluator Alvaro Ramirez Jr.
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20250516100303
FACILITY NAME:TELECARE STEPHANIE HOUSEFACILITY NUMBER:
306006294
ADMINISTRATOR:WOOTEN-NEWMAN, KRISTENFACILITY TYPE:
737
ADDRESS:11702 STEPHANIE LANETELEPHONE:
(657) 667-6382
CITY:GARDEN GROVESTATE: CAZIP CODE:
92840
CAPACITY:4CENSUS: 3DATE:
08/12/2025
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Lead Ahmed Riched, Kristen Wooten-AdministratorTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Facility did not debrief after Crisis Prevention Intervention (CPI) event in a timely manner.
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Alvaro Ramirez, Jr. and Garlli Tat conducted an unannounced visit to deliver findings on the above allegation received on May 16, 2025. LPA was greeted and granted entry into the facility and met with Lead Ahmed Riched. LPA explained the reason for the visit. Administrator (AD) Kristen Wooten was present during the visit.

This Department has investigated the complaint alleging facility did not debrief after Crisis Prevention Intervention (CPI) event in a timely manner. Regarding the allegation the following was revealed: During the course of the investigation LPAs reviewed documents including the Regional Center of Orange County (RCOC) Individual Program Plan (IPP) dated January 8, 2025, for Client 1 (C1). Per IPP, by August 2025 C1 will demonstrate a significant reduction in challenging behaviors. Per IPP, C1 has limited safety awareness and skills. LPAs also reviewed the RCOC Special Incident Reports dated November 2024 to March 2025. Per Special Incident Reports on November 9, 2024, November 11, 2024, November 18, 2024,
CONTINUED ON LIC9099-C...
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2025
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 2
Control Number 22-AS-20250516100303
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: TELECARE STEPHANIE HOUSE
FACILITY NUMBER: 306006294
VISIT DATE: 08/12/2025
NARRATIVE
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November 19, 2024, December 21, 2024, February 2, 2025, February 28, 2025, March 20, 2025, and March 22, 2025, C1 was physically restrained by staff. During the investigation LPAs reviewed the Telecare Stephanie House post restraint debriefing tool dated November 2024 to March 2025 for C1. Per post restraint debriefings tool staff conducted a CPI debriefing within 24 hours of each incident. During the course of the interviews with staff, Staff 1 (S1) reported that after a CPI hold that within 24 hours the staff involved in the hold, Administrator, and the Behavior Analyst hold a meeting. S2 stated that when he has been part of a CPI hold that the debriefing has been done within 24 hours.

Based on the information gathered during the investigation and review of documents obtained, LPAs are unable to ascertain if the allegation occurred as reported due to conflicting information. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove or refute the alleged violation occurred; therefore, this allegation is deemed UNSUBSTANTIATED.

For today’s visit, there were no citations issued per Title 22, Division 6 of the California Code of Regulations.


LPA conducted an exit interview with facility representative, and a copy of this report was provided to the facility.

SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2025
LIC9099 (FAS) - (06/04)
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