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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 336402176
Report Date: 07/13/2022
Date Signed: 07/13/2022 03:53:11 PM


Document Has Been Signed on 07/13/2022 03:53 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
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, CA



FACILITY NAME:STELLA MARIS GROWTH CENTER IIFACILITY NUMBER:
336402176
ADMINISTRATOR:OHAERI, CHARLES S.FACILITY TYPE:
733
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:6CENSUS: 4DATE:
07/13/2022
TYPE OF VISIT:Case Management - Law Enforcement ContactsANNOUNCEDTIME BEGAN:
09:43 AM
MET WITH:Charles OhaeriTIME COMPLETED:
03:57 PM
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Licensing Program Analyst Latricia Rogers & Licensing Program Manager Angela King conducted a case management inspection on July 13,2022 @ 9:43 am, based on the number of relevant law enforcement contacts reported by the facility, pursuant to Health and Safety Code section 1538.7. During this inspection, 9 out of 11 Direct Care Staff and 4 out of 4 youth files were reviewed. 3 out of 11 Direct Care Staff and 2 out of 4 youth were interviewed. (See the Confidential Names List, LIC 811, dated July 13, 2022). The Plan of Operation including policies and procedures were reviewed.

Based on the analysis of the confidential interviews and youth file review including the needs and service assessments, youth case plans, and crisis intervention plans, the licensee uses trauma-informed and evidence-based de-escalation and intervention techniques when staff is responding to the behavior of a youth residing in the facility. Interviews with youth and staff indicate the licensee prohibits calls or threats to call law enforcement as a form of discipline.

LPA Latricia Rogers observed documentation of completed training records indicating staff have been trained on Emergency Intervention as required. The licensee is contacting law enforcement in accordance to their Emergency Intervention Plan when there is an immediate risk of serious harm to a child or others.

There are no deficiencies cited at this time. A copy of this report was discussed and provided to Charles Ohaeri, Administrator.

SUPERVISOR'S NAME: Angela KingTELEPHONE: (323) -981-3857
LICENSING EVALUATOR NAME: Latricia RogersTELEPHONE: 951-217-0236
LICENSING EVALUATOR SIGNATURE:
DATE: 07/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/13/2022
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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