366428030-11-10-2021-19-CR-JSMH-C9G2Z7-20211206164952

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 366428030
Report Date: 11/10/2021
Date Signed: 11/10/2021 05:31:34 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 600
RIVERSIDE, CA 92501

This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/30/2021 and conducted by Evaluator Carmen Escobar

PUBLIC

COMPLAINT CONTROL NUMBER: 19-CR-20210930101832

FACILITY NAME:	A NEW BEGINNING FOSTER FAMILY AGENCY		FACILITY NUMBER:	366428030
ADMINISTRATOR:	MOHAMMED, SUZETTE		FACILITY TYPE:	430
ADDRESS:	15729 MAIN STREET		TELEPHONE:	(760) 244-8337
CITY:	HESPERIA	STATE:	ZIP CODE:	92345
CAPACITY:	75	CENSUS: 58	DATE:	11/10/2021
		UNANNOUNCED	TIME BEGAN:	04:40 PM
MET WITH:	Administrator-Dr. Suzette Mohammed & Intake Coordinator-Nadine Leefook-Little		TIME COMPLETED:	05:45 PM

ALLEGATION(S):

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Minor sustained unexplained injuries while in care.
Foster parent does not provide adequate supervision.

INVESTIGATION FINDINGS:

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On November 10, 2021 at 4:40 PM, Licensing Program Analyst (LPA) Carmen Escobar conducted an unannounced inspection at the foster family agency (FFA) in order to issue the investigative findings for the above allegations. During the investigation, LPA requested documents from foster child 1 (FC1’s), foster child 2 (FC2’s), and foster child 3 (FC3’s) files including placement agreements, copy of needs and service plans for each foster child, and special incident reports involving all foster children in regards to the allegations reported. LPA also obtained a copy of the resource family home (RFH’s) certification approval, training history, placement history, and case notes from agency social worker (ASW). LPA Escobar conducted interviews with resource mother (RM), resource father (RF), FC1, FC2, FC3, FC1 and FC2’s county social worker (CSW), and ASW. LPA Escobar completed the initial ten-day inspection at the RFH in person to initiate the complaint on 10/05/21 at 12:15 PM. No safety concerns were observed.

It was alleged that on or around 09/30/21, FC1 sustained unexplained injuries while in care and also RM and RF do not provide adequate supervision. Specifically, it was detailed that a witness who was unable to

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Jennifer Smith	TELEPHONE: (951) 782-4969
LICENSING EVALUATOR NAME: Carmen Escobar	TELEPHONE: (951) 447-1158
LICENSING EVALUATOR SIGNATURE:	DATE: 11/10/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2021

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

LIC9099 (FAS) - (06/04)

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Control Number 19-CR-20210930101832

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 600
RIVERSIDE, CA 92501

FACILITY NAME: A NEW BEGINNING FOSTER FAMILY AGENCY	FACILITY NUMBER: 366428030
	VISIT DATE: 11/10/2021

NARRATIVE

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speak with the foster children, observed that FC1 had a linear scratch on FC1’s neck and a gray bruise under FC1’s left eye. This witness addressed concern about supervision to the RF and RF gave no response. Per allegation details, it was reported that a while back, FC1 also had a bite mark on FC1’s back and it was reported to witness that FC3 had bit FC1, therefore, witness is concerned about supervision being provided to foster children. RM and RF both deny leaving any of the foster children unsupervised at any time, then or now. RM, RF, and CSW, all corroborate that even when the children are supervised, FC1, FC2, and sometimes FC3, play rough and will sometimes give each other superficial injuries “as children do”. RM, RF, and CSW, all corroborate that resource parents also separate the children any time they are playing rough. CSW and ASW both state they have had absolutely no concerns regarding supervision provided by RM and RF at the RFH. Several witnesses state they feel safe in the RFH, however, would not provide any additional details regarding the allegations.

Based on interviews conducted and information obtained, the allegations that FC1 sustained unexplained injuries while in care and also RM and RF do not provide adequate supervision, may have occurred, however, they are not supported or proven by evidence. The allegations are, therefore, UNSUBSTANTIATED. There are no deficiencies to be cited. An exit interview was conducted and a copy of this report, LIC 811, and appeal rights, were provided to Dr. Mohammed for original signature. Signed report will be placed in facility file.

SUPERVISOR'S NAME: Jennifer Smith	TELEPHONE: (951) 782-4969
LICENSING EVALUATOR NAME: Carmen Escobar	TELEPHONE: (951) 447-1158
LICENSING EVALUATOR SIGNATURE:	DATE: 11/10/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2021

LIC9099 (FAS) - (06/04)

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