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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 336402176
Report Date: 09/21/2022
Date Signed: 09/23/2022 10:15:07 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PACIFIC INLAND CR, 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
04/21/2022 and conducted by Evaluator Cynthia Urena
PUBLIC
COMPLAINT CONTROL NUMBER: 19-CR-20220421110844
FACILITY NAME:STELLA MARIS GROWTH CENTER IIFACILITY NUMBER:
336402176
ADMINISTRATOR:OHAERI, CHARLES S.FACILITY TYPE:
733
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:6CENSUS: 5DATE:
09/21/2022
UNANNOUNCEDTIME BEGAN:
10:40 AM
MET WITH:Facility Manager-Tracy Mitchell TIME COMPLETED:
11:30 AM
ALLEGATION(S):
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Minor is not provided clothing.

INVESTIGATION FINDINGS:
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On September 21, 2022, at 10:40AM, Licensing Program Analyst (LPA) Cynthia Urena met with Stella Maris Growth Center Short Term Residential Therapeutic Program (STRTP) Facility Manager, Tracy Mitchell to deliver the investigative findings for the above stated allegation.

On April 21, 2022, Community Care Licensing received a complaint alleging that minor has access to dangerous objects, staff yells at minor while in care, staff does not treat minor with dignity and respect, and minor is not provided clothing.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Abdoulaye Traore
LICENSING EVALUATOR NAME: Cynthia Urena
LICENSING EVALUATOR SIGNATURE:

DATE: 09/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2022
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 5
Control Number 19-CR-20220421110844
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PACIFIC INLAND CR, 3737 MAIN ST., SUITE 600
RIVERSIDE, CA 92501
FACILITY NAME: STELLA MARIS GROWTH CENTER II
FACILITY NUMBER: 336402176
VISIT DATE: 09/21/2022
NARRATIVE
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On April 28, 2022, at 12:25PM Licensing Program Analyst (LPA) S. Smith initiated the investigation at Stella Maris Growth Center Short Term Residential Therapeutic Program (STRTP). At 1:40PM, LPA S. Smith conducted a safety inspection, and no immediate hazards were observed. Additionally, LPA Smith conducted interviews with Staff 1 (S1), Client 1 (C1), Client 2 (C2), and Client 3 (C3). Client 4 (C4) refused to be interviewed.

On April 21, 2022, Community Care Licensing received a complaint alleging that minor is not provided clothing. 

Confidential interviews stated that the STRTP provides clients with $150.00 clothing allowance. Confidential interviews further stated that clients shop for clothing on a quarterly basis. A confidential interview stated that C5 did not have a lot of clothes. It was disclosed that C5 had been expedited a clothing allowance due to the lack of clothing. Confidential interview further stated that C5 did complain that C5 was being made fun of at school for wearing the same clothes. Confidential interview further stated that this was an issue at beginning of C5’s placement at the STRTP. A confidential interview stated that it took the STRTP longer to issue a clothing allowance for C5 than other clients who were placed at the STRTP. A confidential interview stated that C3 was in placement at the STRTP for two months and had not been awarded a clothing allowance.
During file review, LPA Smith noted in the STRTP’s program statement on page 313 of 336 Adequate clothing, STRTP provides $75.00 clothing allowance per month to each child and NMD. Based on confidential interviews the facility is not providing clients with the monthly $75.00 clothing allowance as stated in their program statement. Confidential interviews stated that the STRTP provides clients with a $50.00 monthly clothing allowance.
Based on confidential interviews and file reviews, the preponderance of evidence standard has been met, and the allegation that C5 was not provided clothing is supported and proven by evidence. The facility is cited for violation of Short-Term Residential Treatment Facility (STRTP) Interim Licensing Standards Section 87022.1(a) PROGRAM STATEMENT


Exit interview was conducted and a copy of this report along with the appeal rights was provided to Facility Manager Tracy Mitchell.
SUPERVISORS NAME: Abdoulaye Traore
LICENSING EVALUATOR NAME: Cynthia Urena
LICENSING EVALUATOR SIGNATURE:

DATE: 09/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 19-CR-20220421110844
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PACIFIC INLAND CR, 3737 MAIN ST., SUITE 600
RIVERSIDE, CA 92501

FACILITY NAME: STELLA MARIS GROWTH CENTER II
FACILITY NUMBER: 336402176
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/21/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/21/2022
Section Cited
ILS
87022.1(a)
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87022.1(a) PROGRAM STATEMENT … the program statement shall demonstrate an understanding and ability… to meet the *individual* needs of children …and the population(s) being served.This requirement was not met as evidenced by:

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Licensee informed LPA C. Urena that STRTP will operate according to their program statement, and will provide clients with $75.00 of clothing allowance monthly. Licensee will send LPA a written statement with the above information by 09/28/22
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Based on interviews and documentation, the facility did not ensure clients received the correct clothing allowance as stated in the STRTP Program Statement. This poses a potential health, safety and personal rights risk to the children 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: Abdoulaye Traore
LICENSING EVALUATOR NAME: Cynthia Urena
LICENSING EVALUATOR SIGNATURE:

DATE: 09/21/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PACIFIC INLAND CR, 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
04/21/2022 and conducted by Evaluator Cynthia Urena
PUBLIC
COMPLAINT CONTROL NUMBER: 19-CR-20220421110844

FACILITY NAME:STELLA MARIS GROWTH CENTER IIFACILITY NUMBER:
336402176
ADMINISTRATOR:OHAERI, CHARLES S.FACILITY TYPE:
733
ADDRESS:13530 SYLMAR DRIVETELEPHONE:
(951) 653-6958
CITY:MORENO VALLEYSTATE: CAZIP CODE:
92553
CAPACITY:6CENSUS: 5DATE:
09/21/2022
UNANNOUNCEDTIME BEGAN:
10:40 AM
MET WITH:Facility Manager-Tracy Mitchell TIME COMPLETED:
11:30 AM
ALLEGATION(S):
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Minor has access to dangerous objects.
Staff yells at minor while in care.
Staff does not treat minor with dignity and respect.
INVESTIGATION FINDINGS:
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On September 21, 2022, at 10:40AM, Licensing Program Analyst (LPA) Cynthia Urena met with Stella Maris Growth Center Short Term Residential Therapeutic Program (STRTP) Facility Manager Tracy Mitchell to deliver the investigative findings for the above stated allegations.

On April 21, 2022, Community Care Licensing received a complaint alleging that minor has access to dangerous objects, staff yells at minor while in care,and staff does not treat minor with dignity and respect.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Abdoulaye Traore
LICENSING EVALUATOR NAME: Cynthia Urena
LICENSING EVALUATOR SIGNATURE:

DATE: 09/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 19-CR-20220421110844
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PACIFIC INLAND CR, 3737 MAIN ST., SUITE 600
RIVERSIDE, CA 92501
FACILITY NAME: STELLA MARIS GROWTH CENTER II
FACILITY NUMBER: 336402176
VISIT DATE: 09/21/2022
NARRATIVE
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On April 28, 2022, at 12:25PM Licensing Program Analyst (LPA) S. Smith initiated the investigation at Stella Maris Growth Center Short Term Residential Therapeutic Program (STRTP).At 1:40PM, LPA S. Smith conducted a safety inspection, and no immediate hazards were observed. Additionally, LPA Smith conducted interviews with Staff 1 (S1), Client 1 (C1), Client 2 (C2), and Client 3 (C3). Client 4 (C4) refused to be interviewed.
 
On September 14, 2022, at 12:18PM, Licensing Program Analyst (LPA) Cynthia Urena interviewed staff 2 (S2) at the STRTP. On September 19, 2022, LPA Urena conducted telephone interviews staff (S3), staff 4 (S4), and one County Social Worker (CSW).

During the investigation alleging that minor had access to dangerous objects, confidential interviews denied witnessing that C3 had a knife or other dangerous object while C5 was placed at the STRTP. A confidential interview stated that law enforcement conducted a search of C3’s room and did not find a knife or other dangerous object in C3’s belongings. Confidential interviews conducted denied having a dangerous or sharp object in possession. Confidential interviews added not seeing clients with dangerous objects. Another confidential interview stated that C5 had self-harming behaviors while in care and may have used sharp objects, however, the STRTP did not report these incidents to CSW on a timely manner.
Regarding staff yelling at minor while in care or staff did not treat minor with dignity and respect. A Confidential interview stated that staff do not yell at clients but stated that staff can be disrespectful at times. Another confidential interview stated that staff do not yell at clients, but when clients are not listening, it is not unusual for staff to raise their voices. Confidential interview continued stating not witnessing staff being disrespectful to clients. Another confidential interview stated not hearing staff yelling at clients. The confidential interview added that when clients were loud staff do raise their voices to be heard. Other confidential interviews denied yelling at C5 and denied being disrespectful to C5 when placed at the STRTP. Another confidential interview stated that C5 did not report any concerns about the staff treatment at the STRTP.

Based on confidential interviews, the allegations that C3 had access to dangerous objects, staff yells at C5 while in care, and that staff does not treat C5 with dignity and respect may have occurred, however, it is not supported or proven by evidence. There was not a preponderance of evidence to support or deny the allegations, therefore, these allegations are unsubstantiated at this time. Exit interview was conducted and a copy of this report along with the appeal rights was provided to Facility Manager Tracy Mitchell.
SUPERVISORS NAME: Abdoulaye Traore
LICENSING EVALUATOR NAME: Cynthia Urena
LICENSING EVALUATOR SIGNATURE:

DATE: 09/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2022
LIC9099 (FAS) - (06/04)
Page: 5 of 5