C O U N T Y OF L O S A N G E L E S DEPARTMENT OF AUDITOR-CONTROLLER

KENNETH HAHN HALL OF ADMINISTRATION 500 WEST TEMPLE STREET, ROOM 525 LOS ANGELES, CALIFORNIA 90012-3873 PHONE: (213) 974-8301 FAX: (213) 626-5427
WENDY L. WATANABE
AUDITOR-CONTROLLER ASST. AUDITOR-CONTROLLERS

ROBERT A. DAVIS JOHN NAlMO JUDI E. THOMAS

May 12,2011

TO:

Supervisor D. Antonovich, Michael Mayor Supervisor Gloria Molina Supervisor Mark Ridley-Thomas Supervisor Zev Yaroslavsky Supervisor Don Knabe Wendy L. Watanabe Auditor-Controller SECURE TRANSITIONS REVIEW A DEPARTMENT OF PROVIDER

FROM: SUBJECT:

CHILDREN

FOSTER AND

FAMILY FAMILY

We have Agency (DCFS) Transitions County follow-up

completed a contract compliance review of (Secure Transitions or Agency), a Department provider. of The review was to our purpose determine whether was the services providing outlined in their Program Statement contract. We completed our review during October and conducted 2008 a review in March 2010. a private children to monitor Transitions placed at Secure $656,000

DCFS contracts with Secure Transitions, organization to recruit, fostertrain parents certify for supervising and places in foster care. Once Agency places child,ait is required the placement child is discharged until the the program. from Secure 26 certified foster in which 32 DCFS homes children were review. Secure is located in the Transitions Second DCFS paid District. Transitions approximately $662,000 and 2009-10, respectively. Results of Review Secure complied Title 22 Transitions always ensure that not did the County contract and California with the regulations. during our follow-up In addition, foster Department in 2010, review homes,

staff case of Social Secure Transitions

Help Conserve Paper - Print Doc /hie-Sided "To Enrich Lives Through Effective and

Caring

Service"

Board of May 12,2011 Page 2 still had example:

Supervisors

not

resolved

that existed of many during our 2008 review. For the issues

Two (40%) of the five Needs and Services in 2008 Plans (NSPs) contained re inaccurate information and did not on include emancipation a thoroug readiness issues. four (80%) addition, In the five of NSPs not did have goals tha were specific, ormeasurable and some of time-limited the goals were agenot appropriate. This also noted in our wasSecure issue Transitions contra report issued on April 24, 2007. During our follow-up review in 2010, NSPs reviewed had additional all three appropriate However, one goals. (33%) NSPs had conflicting the of information. Secure Transitions' all NSPs to ensure accuracy attached and response goals. they

that

re view indicates include appropria

One (50%) of the two NSPs reviewed in 2008 for children taking medication not include did a discussion the children's on theuse of medication required. This issue was also noted in our report issued on April 24,

psychot as 2007.

During our follow-up inreview one (33%) 2010, of three additional the NSPs reviewed for children taking psychotropic include a medication discussion did on the children's the use medication. of all three In addition, children's not case files have required documentation by the of monthly prescribing evaluations physicia and not have did up-to-date medication the foster parents and However, logs. the children indicated were taking that they their medication were seen monthly and by the prescribing physician. Secure a discussion Transitions' on attached use of children's the psychotropic response NSPs indicates ensure include medication.

Three (60%) of the case five the children's DCFS social children's progress.

files in 2008 reviewed not have did documentation that workers were monthly updates on thewith provided

During our follow-up in review all five 2010, additional files reviewed case not did have documentation DCFS social that the children's workers were provide monthly updates. For three children, documented update was last the five months old and for two children, the last documented two months old. update was Secure Transitions' workers contact DCFS monthly Two (40%) of the five years old) for services children and attached response will ensure with updates progress. the on indicates social their children's

in 2008 reviewed exceeded the maximum age (17 the Agency did not have

docum

Board Supervisors of May 12,2011 Page 3 from CDSS Community Care Licensing (CCL) as required. This issue was also noted in our report issued on April 24, 2007.
f

During our follow-up review in 2010, two (67%) the of three additional children reviewed exceeded the maximum age and the Agency did not have documentation of an exception from CCL.
Secure Transitions' attached response indicates that they will ensure that all children meet the age criteria.

Two (40%) of the five children reviewed in 2008 received initial dental examinations 51 and 84 days late, respectively. This issue also noted in our report issued on was April 24, 2007. During our follow-up review in 2010, two (67%) of the three additional children reviewed both received initial dental examinations 13 days late.
Secure Transitions' attached response indicates that they will remind foster parents of medical and dental examination due dates to ensure children receive examinations timely.

Details

our review, along with recommendations for corrective action, are attached. of

Review of Report
We discussed our report with Secure Transitions on January 18, 2011. In their attached response (Attachment I), Secure Transitions management indicates the actions the Agency has taken to implement the recommendations. We also notified DCFS of the results of our initial and follow-up reviews. In their response (Attachment II), DCFS indicates that, due to the repeated findings, they will assess the Agency for full implementation of our recommendations within six months and determine if progressive action warranted. is We thank Secure Transitions management for their cooperation and assistance during our review. Please call me if you have any questions or your staff may contact Don Chadwick at (213) 253-0301.
Attachments c: William T Fujioka, Chief Executive Officer Jackie Contreras, Ph.D, Interim Director, DCFS Linda Lakso, Board of Directors Chair, Secure Transitions Dr. Melvin Moore, Executive Director, Secure Transitions Jean Chen, Community Care Licensing Public Information Office Audit Committee

FOSTER FAMILY AGENCY SECURE TRANSITIONS FISCAL YEARS 2008-09 AND 2009-1 BACKGROUND

PROGRAM FOSTER 0

FAMILY

The Department of Children and Family Services Foster Family (Secure Transitions Agency Agency) or negotiated a monthly ra child placement, by the established California Department (CDSS) of Social Foster Care Rates Bureau. on the child's Based age, Agency the receives between Secure Transitions app $1,430 and $1,679 per month, DCFS paid per child. $662,000 and $656,000 during Fiscal Years (FY) 2009-10, respectively. and 2008-09
PURPOSEIMETHODOLOGY

The purpose of our review to determine was whether Secure Transition the services in their outlined Program Statement and reviewed County We the certified foster parent files, children's case the files, pe Agency's staff. We also visited a of certified number fosterand interviewed the homes children and foster parents. completed We our review during and Octo conducted a follow-up in March 2010. review
BILLED Obiective SERVICES

Determine whether Secure their County contract and CDSS Title 22 regulations.
Verification

Transitions in accordance provided

with pro

We visited three of the 26 Los Angeles County certified foster ho Transitions billed interviewed and DCFS three and five foster foster parents children placed in the three homes. In addition, we reviewed the case files for parents and five children we reviewed the and Agency's monitoring activit March 2010, we visited two foster reviewed and homes additional foster p children's case files.
Results

During our 2008 Secure Transitions review, did not always comply contract requirements Title 22 regulations. For example, the CDSS and Agency not did ensure that foster parent certification files, and Services children's case Plans (NSPs) and Quarterly had all Reports the required information. The did not ensure children's initial and Quarterly examinations dental Reports w completed timely, accurate and approved were NSPs DCFS by social workers, an
AUDITOR-CONTROLLER COUNTY OF LOS ANGELES

Secure Transitions

Family Agency Foster

Page 2

DCFS social workers were provided with monthly updates on the children's progress. In addition, Secure Transitions did not renew exceptions obtained from CDSS Community Care Licensing (CCL) before billing DCFS for children that exceeded the maximum age for services. During our follow-up review in 2010, Secure Transitions still had not resolved many the of conditions that exkted during our 2008 review. Specifically, we noted the following: Foster Parent Certification One (33%) the three foster homes reviewed in 2008 was not assessed by Secure of Transitions ensure the foster parents could care for more than two children. At to the time of our review, three children were placed in the home. This issue was also noted in our Secure Transitions contract review report issued on April 24, 2007. During our follow up-review in 2010, we confirmed that home from our 2008 the review and two additional homes reviewed were appropriately assessed. Two (67%) the of three foster parents reviewed in 2008 did not complete the required 15 hours of annual continuing education training. At the time of our review, the two foster parents had completed five and 12 hours of training, respectively. This issue also noted in our report issued on April 24, 2007. was During our follow-up review in 2010, the four additional foster parents reviewed completed the required training. One (33%) of the three foster parent files reviewed in 2008 did not include a current driver's license and proof of auto insurance. This issue was also noted in our report issued on April 24, 2007. In addition, the foster parent's CPR certificate had expired. Subsequent to our review, the Agency provided documentation of a current driver's license and proof of auto insurance. In addition, the foster parent completed the required CPR training. During our follow-up review in 2010, the foster parent's proof of auto insurance was no longer current. In addition, one (33%) of the three additional foster parents' files reviewed did not have a current CPR certificate. Needs and Services Plans and Children's Case Files Four (80%) five NSPs reviewed in 2008 were not approved by the DCFS the of social workers as required. This issue was also noted in our report issued on April 24, 2007. During our follow-up review in 2010, all three additional NSPs reviewed were not approved by the DCFS social workers.

AUDITOR-CONTROLLER COUNTY OF LOS ANGELES

Secure

Transitions Family Agency Foster

Pane 3

Two (40%) of the five NSPs reviewed in 2008 contained inaccurate Specifically, NSPs indicated the the werechildren 14 years old, were under too young for emancipation services and were were 19 yearunemployed old young adults and were theemployed. two NSPs not include addition, did In a thorough discussion on emancipation readiness issues.

(33%) of the three addition During our follow-up inreview one 2010, reviewed had conflicting information. Specifically, Family that the Reunification services but later were indicates completed that Family R services not were yet completed.

Four (80%) five of the NSPs in 2008 reviewed not have goals did that were specific measurable or time-limited. In addition, some of the goals in the NSPs not were age-appropriate. This issue report was issued on April 24, noted also 2007. in our During our follow-up that were specific, in review all three 2010, measurable additional NSPs and time-limited. reviewed

One (50%) of the two NSPs reviewed in 2008 for children taking psychotropic medication not include did a discussion on the children's us in our issued 24, 2007. April on required. This alsoissue noted report was

(33%) of the three addition During our follow-up inreview one 2010, reviewed for children taking psychotropic medication the children's of the medication. In addition, all three use children's not case files have required documentation by the prescribing of monthly evaluations physician However, the foster parents and the and did not have up-to-date medication logs. children indicated that they were taking their medication and the prescribing physician. One (20%) of the five Quarterly Reports reviewed in 2008 was months late. issue was also noted in our This report issued on April 2007. 24, prepared

During our follow-up 2010, in review of the four three (75%) additional Reports reviewedprepared were Two of the reports were prepared late. approximately one month late and one was

Quarterly prepared

* Two (40%) of the

five Quarterly reviewed in 2008 Reports the children's on their progressgoals as required. report issued 24, 2007. April on During our follow-up in review two 2010, (50%) Reports reviewed not include did details of

did not include This alsoissue in our noted was of the in the four children's 2008 the did

det

additional progress not

Two (40%) of the five children's report

Quarterly reviewed Reports cards as required.

in

AUDITOR-CONTROLLER COUNTY OF LOS ANGELES

Secure Transitions Foster Familv Anencv

Pane 4

During our follow-up in review one (25%) of the four additional Quarterly 2010, Reports reviewed did not include the children's report cards. Three (60%) of the five case files reviewed in 2008 did not have documentation the children's DCFS social workerstwere provided with monthly updates on the children's progress. During our follow-up review in 2010, all five additional case files reviewed did not have documentation that the children's DCFS social workers were provided with monthly updates. For three children, the last documented update was five months old and for two children, the last documented update was two months old. One (20%) of the case files reviewed in 2008 not have documentation five did the children or their DCFS social workers were informed of the children's personal rights and the Agency's policies and procedures as required. This issue was also noted in our report issued Aprilon 2007. 24, During our follow-up review 2010, all four additional case files in reviewed documented that the children or their social workers were appropriately informed. Two (40%) of the children reviewed in 2008 exceeded the maximum age five (17 years old) for services and the Agency did not have documentation of an exception from CDSS CCL as required. This issue was also noted in our report issued on April 24, 2007. During our follow-up review 2010, two (67%) of the three additional children in reviewed exceeded the maximum age and the Agency did not have documentation of an exception from CCL. Two (40%) of the five children reviewed in 2008 received initial dental examinations 51 and 84 days late, respectively. This issue was also noted in our report issued on April 24, 2007. During our follow-up review 2010, two (67%) of the three additional children in reviewed both received initial dental examinations 13 days late.
Recommendations Secure Transitions management ensure: 1. 2. Assessments are completed for homes where more than two are placed. children

th

th

Foster parent certificationhave all the required information files including documentation hours, CPR certificates, training of licenses, and proof of automobile insurance.
AUDITOR-CONTROLLER COUNTY OF LOS ANGELES

driver's

Secure Transitions Foster Family Agency

Page 5

3.
4.

NSPs are accurate and approved by the DCFS social workers. NSPs include goals specific, measurable and time-limited. are that taking psychotropic of the use medication. a

5.
6.

NSPs for children discussion on the children's

medicat

Quarterly Reports are prepared and include the children's timely progress toward achieving goals.

7. Quarterly Reports include children's report cards.

8.
9.

DCFS social progress.

workers are updated

monthly

the children's regarding

Children meet the age criteria for services. the Agency's of

10. Children and the DCFS social workers are informed policies and procedures.

I .Children's initial dental examinations are conducted timely. I

CLIENT VERIFICATION Obiective

Determine Transitions
Verification

whether to DCFS. billed

the

received the services program participants

that

Secure

We interviewed homes and three

foster

five in three of children Secure placed Transitions' parents services confirm billed to DCFS. the to Agency the

certifie

The foster parents expectations.

children indicated

indicated with living their they enjoyed the parents foster and foster that they received services from the the Agency

Recommendation None.

AUDITOR-CONTROLLER COUNTY OF LOS ANGELES

Secure Transitions Foster Family Agency STAFFINGICASELOAD LEVELS Objective

Page 6

Verify that Secure Transitions social wockers' caseloads do not exceed 15 placements and that the supervising social worker does supervise more than six social workers not as required by the County contract and CDSS Title 22 regulations. Verification We interviewed Secure Transitions' administrator and reviewed caseload statistics and payroll records for the Agency's social workers and supervising social worker. Results At the time of our 2008 review, Secure Transitions' three social workers carried an 12 cases and the Agency's supervising social worker supervised average caseload of three social workers. However, Secure Transitions has a part-time contract social worker that not sign a declaration stating that their combined caseload at all did agencies will not exceed 15 children as required. This issue was also noted in our report issued on April 24,2007. During our follow-up review in 2010, Secure Transitions did not have any contracted social workers. Recommendation
12. Secure Transitions management ensure that contract social workers sign declarations stating that their combined caseload at all agencies will not exceed 15 children.

STAFFING QUALIFICATIONS Obiective Determine whether Secure Transitions' staff possess the education and work experience qualifications required by their County contract and CDSS Title 22 regulations. In addition, determine whether the Agency conducted hiring clearances prior to hiring their staff and provided ongoing training to staff. Verification We interviewed Secure Transitions' administrator and reviewed each staffs personnel file for documentation to confirm their education work experience qualifications, and hiring clearances and ongoing training.

AUDITOR-CONTROLLER COUNTY OF LOS ANGELES

Secure Transitions Results

Secure the Agency on the

Familv Agency Foster

Page 7

Transitions' staff possessed the required education experience and work conducted and provided clearances hiring ongoing training County contract.

and for

Recommendation None. PRIOR YEAR Obiective

Determine the status of the recommendations monitoring review. in the prior reportedAuditor-Controller

FOLLOW-UP

Verification
We verified the whether outstanding recommendations 2005-06 the FY review were implemented. was issued Aprilon The24, report 2007. monitoring from

Results

The Agency fully has Our April 24, 2007 monitoring 17 had recommendations. report implemented ten recommendations and partially implemented one recom However, the Agency has not implemented six recommendations primarily assessing foster homes, certifying the children for that foster parents services, dental exam timeliness, NSPs, completing and contract andsociala worker caseloads.

Recommendation
13. Secure Transitions recommendations

management implement the frommonitoring report. the April

outstanding 24, 2007

AUDITOR-CONTROLLER COUNTY OF LOS ANGELES

Attachment I Page 1 of 9

Attachment I Page 2 of 9

I=QUNTr(OF L Z AWQELES CS DEPARTMENT OF AUD~TOR-60MTR01.1.ttt ER

SECURE TRANSI"T1ONS FOSTER FAlrJIlkY AGENCY CONTRACT R E V I W

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T?a sqanq;.'s nEvi campliance .jys:en~.r cx3ez:ed tg i n c ~ a r i e ager:P;y scd:ai wr,c*ftrr;' shilCis] to adhorc I 0 : . ~ ~ l i f i X l ~ rpslicies, and praced~rdsand to increase t h ~ i zrailiQ 1 ?%, r 0 s u ~ ~ " ~ f - ~ s fu1511lYwir ru$porr:; isili~cts place3 r;hiMren, 1~ cxc;i.rlrfi~d f~.~ ly $0 paroi'lts, nr~d thn tz

rrcjlc*y,t.

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Attachment I Page 3 of 9

C l k a .a g m q ' ~ ~~ ~oIIc/B% and prwsdum with ~ w d @aced chitderl y within thred (3)day$ uf plauprnfmt.
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Attachment I Page 4 of 9

PdaeQcanQ Ssrusiclras Plan:

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b'b3fl ,4Fas' SCdT3, I+~ze3xiy, lrti tip~11~1E~fl iZle~d5 ard 6snlices Plans.

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placed ri$ d aver fc~ufiws~ :b (14) yfid1r.4 ~ ? l fage c n yoLr caseiced

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Attachment I Page 5 of 9

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Attachment I Page 6 of 9

Medirwl and Dental Exa~~lirialians:

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Attachment I Page 7 of 9

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Attachment I Page 8 of 9

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~ttachment II Page 1 of 2

Attachment II Page 2 of 2

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