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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 392700629
Report Date: 08/15/2023
Date Signed: 08/21/2023 11:25:55 AM

Document Has Been Signed on 08/21/2023 11:25 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, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME:G.L.O.M. A.R.F. 3FACILITY NUMBER:
392700629
ADMINISTRATOR:ALEXANDRA ARCHANGELFACILITY TYPE:
772
ADDRESS:1117 SOUTH GRANT STREETTELEPHONE:
(209) 330-7155
CITY:STOCKTONSTATE: CAZIP CODE:
95206
CAPACITY: 15CENSUS: DATE:
08/15/2023
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Bruce SheppardTIME COMPLETED:
04:30 PM
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On 8/15/23 at 3:00pm the Department conducted an Informal Meeting via Microsoft Teams with representatives from G.L.O.M. (God’s Love Outreach Ministries) to address the 4th quarter fiscal monitoring, resulting from the Solvency Audit conducted by the Department. Present at the meeting were Assistant Program Administrator Pam Gill, Regional Managers (RM) Brenda White, Licensing Program Manager(s) Czarrina Camillon-Lee, Stephen Richarson, Liza King, Isaac Taggart and Sergiy Pidgimy, Licensing Program Analyst Kevin Gould and Albert Johnson, Jacqueline Juarez Supervising Auditor and Jorge Mojica Auditor, Lisa Evans, Licensee Representative for G.L.O.M., Bruce Shepard CPA/Consultant for G.L.O.M and Jacob Reinhardt, licensees legal consul.

Department auditors presented the Audit Objectives and Findings

1) Confirm each facility generates sufficient income to meet current financial obligations. Although licensee reports positive income during the period, organization continues to rely on advance sales of its receivable to fund operations. In addition, licensee did not provide all requested documents (to allow validation of reported amounts).

2) Confirm licensee maintains sufficient cash reserves to ensure provision of care and supervision to clients. As a whole, the organization does not maintain sufficient cash reserves to ensure provision of care and supervision to clients. Licensee did not provide all requested documents (to allow validation of reported amounts). In addition, it appears licensee did not report all of the organization's liabilities (eg SBA loan & EDD lien).

Report Continued on LIC 9099-C

SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Kevin Gould
LICENSING EVALUATOR SIGNATURE: DATE: 08/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/17/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME: G.L.O.M. A.R.F. 3
FACILITY NUMBER: 392700629
VISIT DATE: 08/15/2023
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3) Confirm licensee paid facility leases timely and in full. Leases are paid.

The Licensee agreed to provide to Jacqueline.Juarez@dss.ca.gov the following documentation by 8/21/23 to address the concerns stated above:

1. Documentation of all utility bills that were identified as past due current and up to date.

2. Documentation confirming the Licensees new line of credit in the minimum amount of $918,000.00 that was unable to be verified by department auditors.

3. Clarification of all indirect charges for all loans and their allocation to each facility.

The Department advised the Licensee of the Department’s inspection authority and reminded the licensee they are required by Title 22 regulations to provide requested documentation in a timely and complete manner. The Department also advised the Licensee of the exclusion of Dr. Turner and the individual is barred from making or signing any agreements of behalf of the licensee. The Department also advised the Licensee of the reporting requirements outlined in California Health and Safety Code if and when a utility has sent notification of intent to terminate electricity, gas or water service.

The Department agreed to the licensee providing additional documentation and scheduled a follow up virtual office meeting for 9/19/23 at 3:00pm with all parties present during today’s virtual office meeting.

The licensee informed the Department of a change in Corporate Structure during todays meeting. The Board will need to name an acting CEO and provide a list of the names of the board of directors. If the board does not appoint and provide a CEO, all board members will need a background clearance as the Board is considered as having operational control.

Report Continued on LIC 9099-C

SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Kevin Gould
LICENSING EVALUATOR SIGNATURE:

DATE: 08/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2023
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME: G.L.O.M. A.R.F. 3
FACILITY NUMBER: 392700629
VISIT DATE: 08/15/2023
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Please provide the following to Sergiy.Pidgirny@dss.ca.gov for each existing licensed facility the:

· LIC 200, LIC 308, LIC 309

· Board Resolutions

· Organizational Chart

· List of Board of Directors,

For Each new Board member (in the absence of a CEO) please provide the:

· LIC9182 for each Board Member for each facility with ID

The Licensee was unable to sign the report at the time of the meeting a phone call to review the report with the licensee was scheduled and a copy of this report was provided to the licensee via email to sign and return to Czarrina.Camilon-Lee@dss.ca.gov.

No citations were issued.

SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Kevin Gould
LICENSING EVALUATOR SIGNATURE:

DATE: 08/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2023
LIC809 (FAS) - (06/04)
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