Sacramento County CSA Report - Final 5-30-17

California - Child and Family Services Review County Self-Assessment 2016 – 2021 Final May 30, 2017

California - Child and Family Services Review Table of Contents Contents INTRODUCTION .................................................................................................................................... 7 C-CFSR PLANNING TEAM & CORE REPRESENTATIVES................................................................................. 8 C-CFSR TEAM ................................................................................................................................. 8 CORE REPRESENTATIVES .................................................................................................................... 8 THE CSA PLANNING PROCESS............................................................................................................. 9 PARTICIPATION OF CORE REPRESENTATIVES .......................................................................................... 9 STAKEHOLDER FEEDBACK – FOCUS GROUPS.......................................................................................... 9 CHILD WELFARE EXECUTIVE MANAGEMENT TEAM (EMT) FOCUS GROUP: ............................................ 9 CPS SUPERVISORS FOCUS GROUP: ................................................................................................ 12 CPS SOCIAL WORKER FOCUS GROUP: ........................................................................................... 13 FOSTER PARENT FOCUS GROUP ....................................................................................................14 RELATIVES AND NON RELATED EXTENDED FAMILY MEMBERS (NREFMS) FOCUS GROUP....................... 15 FOSTER YOUTH FOCUS GROUP .....................................................................................................16 PARENT FOCUS GROUP ............................................................................................................... 18 STAKEHOLDER FEEDBACK ............................................................................................................. 21 PROBATION OFFICER FOCUS GROUP:............................................................................................. 28 PROBATION FOCUS GROUPS............................................................................................................. 29 PLACEMENT FOCUS GROUP:.........................................................................................................29 PLACEMENT PARENT FOCUS GROUP:............................................................................................. 29 DEMOGRAPHIC PROFILE ...................................................................................................................... 30 GENERAL COUNTY DEMOGRAPHICS ...................................................................................................30 CHILD MALTREATMENT INDICATORS.............................................................................................. 35 NUMBER AND PROPORTION OF NEWBORNS WITH LOW-BIRTH WEIGHT .......................................... 35 NUMBER AND PROPORTION OF CHILDREN BORN TO TEEN PARENTS................................................ 36 FAMILY STRUCTURE (NUMBER AND PROPORTION OF SINGLE PARENT HOMES, GRANDPARENT HOMES)37 HOUSING COST AND AVAILABILITY............................................................................................. 40 2-1-1 CALLS: MONTHLY AVERAGES BY ASSISTANCE REQUEST ......................................................... 40 SUBSTANCE ABUSE DATA.........................................................................................................41 MENTAL HEALTH DATA ........................................................................................................... 45 CHILD FATALITIES AND NEAR FATALITIES..................................................................................... 46 CHILDREN WITH DISABILITIES (AS APPLICABLE)............................................................................. 48 RATES OF LAW ENFORCEMENT CALLS FOR DOMESTIC VIOLENCE (AS APPLICABLE) ............................... 49 ANALYSIS OF MALTREATMENT INDICATORS................................................................................. 50 CHILD WELFARE PLACEMENT POPULATION ................................................................................. 50 PROBATION PLACEMENT POPULATION ....................................................................................... 62 PUBLIC AGENCY CHARACTERISTICS ........................................................................................................66 POLITICAL JURISDICTIONS................................................................................................................. 66 BOARD OF SUPERVISORS.............................................................................................................. 66 FEDERALLY RECOGNIZED TRIBES....................................................................................................66 1

SCHOOL DISTRICTS/LOCAL EDUCATION AGENCIES............................................................................ 67 California - Child and Family Services Review LAW ENFORCEMENT AGENCIES.....................................................................................................68 PUBLIC HEALTH..........................................................................................................................68 COUNTY CHILD WELFARE INFRASTRUCTURE.................................................................................... 69 EMERGENCY RESPONSE PROGRAM (ER) INTAKE UNIT ...................................................................... 70 EMERGENCY INVESTIGATIONS UNITS.............................................................................................. 70 INFORMAL SUPERVISION PROGRAM............................................................................................... 70 PERMANENCY PROGRAM............................................................................................................. 70 COURT SERVICES ........................................................................................................................ 70 PERMANENCY SERVICES............................................................................................................... 71 NON-CASE CARRYING SUPPORT STAFF........................................................................................... 73 METHODS OF ASSIGNING CASES IN CHILD WELFARE......................................................................... 73 COURT SERVICES/PERMANENCY CASE ASSIGNMENTS ....................................................................... 75 CASELOAD AVERAGES BY SERVICE COMPONENT .............................................................................. 76 STAFF TURNOVER ....................................................................................................................... 80 SUPERVISOR TO SOCIAL WORKER RATIOS ....................................................................................... 82 SALARIES................................................................................................................................... 84 BARGAINING UNIT ISSUES ............................................................................................................ 84 PROBATION INFRASTRUCTURE ......................................................................................................85 JUVENILE HALL...........................................................................................................................87 FINANCIAL/MATERIAL RESOURCES ................................................................................................ 90 CHILD WELFARE OPERATED SERVICES ............................................................................................ 90 COUNTY OPERATED SHELTER....................................................................................................90 FOSTER HOME LICENSING ........................................................................................................91 COUNTY ADOPTIONS............................................................................................................... 91 CHILD WELFARE/PROBATION OTHER COUNTY PROGRAMS................................................................ 91STATE AND FEDERALLY MANDATED CHILD WELFARE/PROBATION INITIATIVES .............................................. 92 CHILD WELFARE .............................................................................................................................92 TITLE IV-E CHILD WELL-BEING PROJECT ........................................................................................ 92 SAFETY ORGANIZED PRACTICE (SOP)............................................................................................. 93 PATHWAYS TO WELL-BEING (FORMERLY KNOWN AS KATIE A. VS BONTA) ........................................... 94 EDUCATION EQUALS INITIATIVE ....................................................................................................95 OTHER ...................................................................................................................................... 96 PROBATION PLACEMENT INITIATIVES .................................................................................................96 FAMILY & CHILDREN COMMUNITY TREATMENT PROGRAM (FCCTP) .................................................. 96 RESOURCE FAMILY APPROVAL (RFA)............................................................................................. 97 CROSSOVER YOUTH PRACTICE MODEL (CYPM) .............................................................................. 97 FEDERAL CASE REVIEWS (FCR) .....................................................................................................97 COMMERCIALLY SEXUALLY EXPLOITED CHILDREN (CSEC).................................................................. 97 WARREN E. THORNTON YOUTH CENTER (WETYC).......................................................................... 98 CHILD AND FAMILY TEAM (CFT) ...................................................................................................98 TITLE IV- E AND TITLE IV WAIVER .................................................................................................98 AGENCY COLLABORATION ............................................................................................................ 99BOARD OF SUPERVISORS (BOS) DESIGNATED COMMISSION, BOARD OF BODIES ........................................... 99 THE BOS-DESIGNATED PUBLIC AGENCY ............................................................................................. 99 CHILD ABUSE PREVENTION COUNCIL (CAPC)...................................................................................... 99 COUNTY CHILDREN’S TRUST FUND COMMISSION, BOARD OR COUNCIL ................................................. 100 PSSF COLLABORATIVE................................................................................................................... 100 2

California - Child and Family Services Review SYSTEMIC FACTORS........................................................................................................................... 100 MANAGEMENT INFORMATION SYSTEMS........................................................................................... 100 MANAGEMENT INFORMATION SYSTEMS - PROBATION........................................................................ 102 CASE REVIEW SYSTEM ................................................................................................................... 102 COURT STRUCTURE................................................................................................................... 102 REVIEW PROCESS ..................................................................................................................... 103 DUAL STATUS YOUTH................................................................................................................ 104 CASE REVIEW CHALLENGES ........................................................................................................ 104 NOTICING ...............................................................................................................................105 CASE PLANNING .......................................................................................................................105 CASE REVIEW SYSTEM - PROBATION ................................................................................................ 106 COURT STRUCTURE................................................................................................................... 106 JUVENILE COURT PROCEEDINGS ..................................................................................................106 DETENTION HEARINGS .............................................................................................................. 106 ARRAIGNMENTS ....................................................................................................................... 107 SETTLEMENT CONFERENCE......................................................................................................... 107 JURISDICTIONAL HEARING .......................................................................................................... 107 DISPOSITIONAL HEARING ........................................................................................................... 107 CONDITIONS OF PROBATION ......................................................................................................108 CHECKING IN AT THE COURTHOUSE.............................................................................................. 108 AFTER THE HEARING ................................................................................................................. 108 REVIEW PROCESS ..................................................................................................................... 108 NOTICING ...............................................................................................................................109 CASE PLANNING PROCESS .......................................................................................................... 109 REFORM EFFORTS..................................................................................................................... 109 FOSTER AND ADOPTIVE PARENT LICENSING, RECRUITMENT AND RETENTION...................................... 110 RECRUITMENT.......................................................................................................................... 110 LICENSURE ..............................................................................................................................110 RETENTION.............................................................................................................................. 110 EVALUATION............................................................................................................................ 111 MAINTAINING STANDARDS ........................................................................................................ 111 PLACEMENT RESOURCES ............................................................................................................ 112 REFORM EFFORTS..................................................................................................................... 113 FOSTER PARENT RECRUITMENT, RETENTION AND SUPPORT (FPRRS)................................................ 113 STAFF, CAREGIVER AND SERVICE PROVIDER TRAINING ........................................................................ 114 STAFF DEVELOPMENT................................................................................................................ 114 SOCIAL WORKER INDUCTION TRAINING........................................................................................ 115 CALIFORNIA COMMON CORE......................................................................................................115 CORE TRAINING PROGRAM FOR SUPERVISORS............................................................................... 116 SOCIAL WORKER AND ALL STAFF TRAINING .................................................................................. 116 PROVIDER TRAINING ................................................................................................................. 117 CAREGIVER TRAINING................................................................................................................ 118 STAFF TRAINING – PROBATION .......................................................................................................119 STAFF DEVELOPMENT................................................................................................................ 119 AGENCY COLLABORATION .......................................................................................................... 119 EXTENDED FOSTER CARE (EFC) ..................................................................................................119 KATIE A ..................................................................................................................................120 EXPECTANT AND PARENTING YOUTH (EPY) .................................................................................. 120 3

FAMILY FINDING AND KINSHIP SUPPORT ...................................................................................... 120 California - Child and Family Services Review COMMERCIALLY SEXUALLY EXPLOITED CHILDREN (CSEC)................................................................ 120 CROSSOVER YOUTH PRACTICE MODEL (CYPM) ............................................................................ 121 PREVENTION INITIATIVE............................................................................................................. 122 FOSTER YOUTH SERVICES........................................................................................................... 122 DEPENDENCY DRUG COURT .......................................................................................................122 TRIBAL PARTNERSHIPS............................................................................................................... 123 LESBIAN, GAY, BISEXUAL, TRANSGENDER, QUEER/QUESTIONING (LGBTQ)....................................... 123 RESOURCE FAMILY APPROVAL (RFA)........................................................................................... 124 PROGRAM EXAMPLE – REDUCTION OF AFRICAN AMERICAN CHILD DEATHS (RAACD) ......................... 124 OTHER AGENCY COLLABORATIONS .............................................................................................. 125SERVICE ARRAY ............................................................................................................................126 REUNIFICATION SERVICES........................................................................................................... 129 ADOPTION SERVICES ................................................................................................................. 130 KINSHIP CARE/SUPPORT SERVICES .............................................................................................. 130 INDEPENDENT LIVING SERVICES...................................................................................................131 PERMANENCY PLANNING SERVICES ............................................................................................. 132 PROGRAMS/SERVICES FOR UNIQUE POPULATIONS......................................................................... 133 CULTURALLY RELEVANT SERVICES................................................................................................ 134 PROGRAMS THAT TARGET UNDERSERVED POPULATIONS .................................................................. 135 SERVICES WHICH ADDRESS THE DEVELOPMENTAL NEEDS OF INFANTS, TODDLERS AND CHILDREN ......... 136 SERVICES AVAILABLE TO CHILDREN AND/OR CAREGIVERS WITH PHYSICAL, MENTAL OR OTHER DISABILITIES136 NATIVE AMERICAN CHILDREN AND INDIAN CHILD WELFARE ACT (ICWA) SERVICES ............................ 137QUALITY ASSURANCE SYSTEM......................................................................................................... 137 EMERGENCY RESPONSE INTAKE PROGRAM ................................................................................... 138 EMERGENCY RESPONSE FIELD PROGRAMS .................................................................................... 138 INFORMAL SUPERVISION PROGRAM............................................................................................. 138 COURT SERVICES PROGRAM .......................................................................................................138 PERMANENCY PROGRAM........................................................................................................... 139 PERMANENCY CASE REVIEW.......................................................................................................139 CHILD AND FAMILY SERVICES REVIEW (CFSR) ............................................................................... 139 MONITORING FOSTER FAMILY AGENCIES (FFAS) ........................................................................... 140 PLACEMENT............................................................................................................................. 140 TEAM DECISION MAKING MEETINGS (TDMS)............................................................................... 141 COMPLIANCE WITH ICWA AND MULTIETHNIC PLACEMENT ACT (MEPA).......................................... 141 MENTAL HEALTH MONITORING ..................................................................................................142 PRESCRIPTION AND PSYCHOTROPIC MEDICATION........................................................................... 142 PHYSICAL HEALTH MONITORING .................................................................................................143 EDUCATIONAL NEEDS................................................................................................................ 143 SPECIAL NEEDS CHILDREN.......................................................................................................... 144 CASE PLANNING PROCESS .......................................................................................................... 144 CONCURRENT PLANNING ........................................................................................................... 144 MEETING TERMINATION OF PARENTAL RIGHTS TIMELINES .............................................................. 145 DEVELOPMENT OF TRANSITIONAL INDEPENDENT LIVING PLAN (TILP) ............................................... 145 PROGRAMS SUPPORTED BY CAPIT/CBCAP FUNDING....................................................................145 COUNTY’S MONITORING MECHANISM OF CAPIT/CBCAP FUNDING ................................................ 147PROGRAMS SUPPORTED BY PSSF FUNDING ...................................................................................... 148COUNTY’S MONITORING MECHANISM OF PSSF FUNDING................................................................... 148 STARS/BRIDGES ...................................................................................................................... 148 4

California - Child and Family Services Review SHORT TERM COUNSELING ........................................................................................................ 149 SIERRA FOREVER FAMILIES ......................................................................................................... 149 INFORMAL SUPERVISION............................................................................................................ 150 POST ADOPTION SERVICES ......................................................................................................... 150 QUALITY ASSURANCE – PROBATION ............................................................................................ 151 CRITICAL INCIDENT REVIEW PROCESS ...................................................................................................151 QUALITY IMPROVEMENT COMMITTEE .............................................................................................. 151 CONTINUOUS QUALITY IMPROVEMENT/QUALITY ASSURANCE (CQI/QA) FRAMEWORK........................... 152 CHILD DEATH REVIEW TEAMS (CDRTS) ........................................................................................... 152 NATIONAL RESOURCE CENTER (NRC) TRAINING AND TECHNICAL ASSISTANCE ............................................ 152 PEER REVIEW SUMMARY ................................................................................................................... 152 FOCUS AREA................................................................................................................................153 METHOD..................................................................................................................................... 153 SUMMARY OF FINDINGS ................................................................................................................ 154 PEER PROMISING PRACTICES .......................................................................................................... 156 CHILD WELFARE OUTCOME DATA MEASURES ....................................................................................... 156 CHILD WELFARE ...........................................................................................................................156 3-S1 MALTREATMENT IN FOSTER CARE............................................................................................ 157 ANALYSIS ....................................................................................................................................157 3-S2 RECURRENCE OF MALTREATMENT ........................................................................................... 158 ANALYSIS ................................................................................................................................158 3-P1 PERMANENCY IN 12 MONTHS (ENTERING FOSTER CARE)............................................................ 159 ANALYSIS ................................................................................................................................159 3-P2 PERMANENCY IN 12 MONTHS (IN CARE 12-23 MONTHS) .......................................................... 160 ANALYSIS ................................................................................................................................160 3-P3 PERMANENCY IN 12 MONTHS (IN CARE 24 MONTHS OR MORE)................................................. 161 ANALYSIS ................................................................................................................................161 3-P4 RE-ENTRY TO FOSTER CARE IN 12 MONTHS ............................................................................... 163 ANALYSIS ................................................................................................................................163 3-P5 PLACEMENT STABILITY........................................................................................................... 164 ANALYSIS ................................................................................................................................164 2B TIMELY RESPONSE ................................................................................................................... 165 ANALYSIS ................................................................................................................................166 2F MONTHLY VISITS (OUT OF HOME).............................................................................................. 167 ANALYSIS ................................................................................................................................167 4A PLACEMENT WITH SOME OR ALL SIBLINGS ................................................................................... 168 ANALYSIS ................................................................................................................................168 4B LEAST RESTRICTIVE PLACEMENT (ENTRIES FIRST PLACEMENT) ......................................................... 169 4B LEAST RESTRICTIVE PLACEMENT (POINT IN TIME).......................................................................... 169 ANALYSIS ................................................................................................................................169 8A – OUTCOMES FOR YOUTH EXITING FOSTER CARE AT AGE 18 OR OLDER ........................................... 170 ANALYSIS ................................................................................................................................170 PROBATION OUTCOME DATA MEASURES ............................................................................................. 172 3-S1 MALTREATMENT IN FOSTER CARE............................................................................................ 172 ANALYSIS ................................................................................................................................172 5

3-P1 PERMANENCY IN 12 MONTHS FOR CHILDREN ENTERING FOSTER CARE.......................................... 173 California - Child and Family Services Review ANALYSIS ................................................................................................................................173 3-P2 PERMANENCY IN 12 MONTHS FOR CHILDREN IN CARE FOR 12-23 MONTHS .................................. 174 ANALYSIS ................................................................................................................................174 3-P3 PERMANENCY IN 12 MONTHS FOR CHILDREN IN CARE FOR 24+ MONTHS .................................... 175 ANALYSIS ................................................................................................................................175 3-P4 REENTRY TO FOSTER CARE .....................................................................................................175 ANALYSIS ................................................................................................................................175 C1.4 REENTRY FOLLOWING REUNIFICATION (EXIT COHORT)................................................................ 176 ANALYSIS ................................................................................................................................176 3-P5 PLACEMENT STABILITY PER 1,000 DAYS................................................................................... 176 ANALYSIS ................................................................................................................................176 2F TIMELY CASEWORKER VISITS WITH CHILDREN............................................................................... 177 ANALYSIS ................................................................................................................................177 2F TIMELY CASEWORKER VISITS IN THE RESIDENCE............................................................................ 177 ANALYSIS ................................................................................................................................177 4B LEAST RESTRICTIVE PLACEMENTS (ENTRIES FIRST PLACEMENT) ....................................................... 178 4B LEAST RESTRICTIVE PLACEMENT (POINT-IN-TIME PLACEMENT) ....................................................... 178 ANALYSIS ................................................................................................................................178 4E ICWA & MULTI-ETHNIC PLACEMENT STATUS .............................................................................. 179 ANALYSIS ................................................................................................................................179 8A OUTCOMES FOR YOUTH EXITING FOSTER CARE AT AGE 18 OR OLDER............................................... 179SUMMARY OF FINDINGS .................................................................................................................... 180 CHILD WELFARE ...........................................................................................................................180 PROBATION .................................................................................................................................182 POPULATIONS AT GREATEST RISK OF MALTREATMENT - AUDITS, INVESTIGATIONS................................... 183 COUNTY STRENGTHS (CYPM – WETYC – FIELD PROGRAMS).............................................................. 184 HOME SUPERVISION AND ELECTRONIC MONITORING ......................................................................... 184 CANDIDACY ASSESSMENT UNIT.......................................................................................................184 YOUTH SERVICE CENTER................................................................................................................ 184 EDUCATION BASED SUPERVISION MODEL-(EBSM)........................................................................... 185 TITLE IV-E WAIVER.......................................................................................................................185 SPECIALIZED SUPERVISION.............................................................................................................. 185 COMMERCIALLY SEXUALLY EXPLOITED CHILDREN (CSEC) .................................................................... 185 SEX OFFENDER/ARSON.................................................................................................................. 185 REDUCING AFRICAN AMERICAN CHILD DEATHS (RAACD) ................................................................... 185APPENDICES ....................................................................................................................................186 APPENDIX A – SUPERVISOR FOCUS GROUP SERVICE ARRAY ................................................................. 186 APPENDIX B – SOCIAL WORKER FOCUS GROUP SERVICE ARRAY ........................................................... 193 APPENDIX C – CPS DIVISION ORGANIZATIONAL CHART....................................................................... 197 APPENDIX D – CPS SERVICE DELIVERY / COURT PROCESS FLOW CHART ................................................ 197 6

California - Child and Family Services Review Introduction California Assembly Bill 636 (Chapter 678, The Child Welfare System Improvement and Accountability Act of 2001) established the Child Welfare Outcomes and Accountability System to meet the following objectives: (a) Improve child welfare services for children and their families in California; and (b) Provide a system of accountability for outcome performance in each of the state’s 58 counties. The process for achieving these two broad objectives is the California Child and Family Services Review (C‐CFSR), which includes both quantitative (Self‐Assessment) and qualitative (Peer Review) assessment of a county’s performance on measures of child safety, permanency, and well-being. The results of the assessments support the development of a System Improvement Plan (SIP) that establishes measurable goals for system improvement and presents strategies for achieving those goals. The C‐CFSR process also includes ongoing monitoring of system improvement efforts using quarterly reports of data extracted from the Child Welfare Services/Case Management System (CWS/CMS). The County Self-Assessment (CSA) Core Planning Team was comprised of 6 members from Child Protective Services (CPS), 3 members from Probation, and 4 representatives from California Department of Social Services (CDSS). The Planning Team met over a period of 6 months to establish a timeline and plan for the peer review, focus groups, and stakeholder meetings. The Peer Review is the process by which counties learn, through qualitative examination of county practice, how to improve services for children and families with respect to one specific focus area. The outcome area chosen by the Planning Team was re-entry into foster care. The process drew upon the expertise of peers from other counties as well as host county social workers and probation officers. During the review, staff from peer counties interviewed Sacramento County case-carrying Social Workers and Probation Officers regarding county practice. Utilizing peers from other counties promotes the exchange of best practice ideas between the host county and the peer counties. Sacramento County hosted the following Peer Counties: Contra Costa, El Dorado, Monterey, Orange, Santa Clara and Ventura. Focus groups were held with the CPS Executive Management Team (EMT) consisting of Division Managers, Program Managers, and Program Planners; with CPS Supervisors, Program Specialists, Social Workers, Family Services Workers, and Child Development Specialist workers; and with Foster Parents, Relatives and Non Related Extended Family Members (NREFMs), Foster Youth, and Parents. Quantitative data was reviewed with CPS staff, and qualitative data was gathered at every Focus Group with an emphasis on Sacramento County’s service array, engagement with families and children, court process, and work force development. Probation utilized internal focus groups that included Probation Officers, Senior Deputy Probation Officers, Supervising Probation Officers, foster youth and the parents of foster youth. All participants were surveyed regarding probation practices in regards to areas of strengths and weaknesses. The C-CFSR process also requires input from stakeholders within the county who participate in providing services to children and families involved in the child welfare system as well as individuals who are receiving or who have received such services. According to the federal Administration for Children and 7

Families (ACF), “’stakeholders’ are defined as courts, tribes, families, youth, caregivers, contracted California - Child and Family Services Reviewproviders, other public entities, community partners, and individuals within the child welfareorganization including administrators, caseworkers, supervisors, and program, policy and training staff.”Stakeholders provided input and guidance in assessing the child welfare system. The stakeholdermeeting was a collaborative effort between Sacramento County CPS, Probation, and CDSS, and wasfacilitated by the Northern California Regional Training Academy (RTA). The stakeholders were placedinto small focus groups to address the areas of re-entry, recurrence of maltreatment, placementstability, and Probation. The results of these small groups were compiled and organized into usable,valuable feedback by the RTA.This County Self-Assessment report will encompass a comprehensive review of our County child welfareand probation practices. The report will determine effectiveness of current practice, programs andresources across the continuum of child welfare and probation placement services and identify areas fortargeted system improvement. C-CFSR Planning Team & Core RepresentativesC-CFSR TeamPrincipal participants in the C-CFSR process include representatives from the County Child Welfare andProbation Placement Agency, the California Department of Social Services (CDSS), and other localcommunity stakeholders. The CDSS provided consultation, support, and assistance to child welfare andprobation to ensure requirements and federal guidelines were met throughout the process.Stakeholders consisting of required participants and other agencies/community organizations thatdeliver services to children and families in Sacramento County were invited to participate in the CSA.Core RepresentativesTo ensure continuous quality improvement, a Core Team was identified to drive the C-CFSR process:Child Welfare:  Verronda Moore, Program Manager, Program Administration  Edward Fernando, Program Planner, Program Administration  Barbara Oleachea, Program Planner, Emergency Response  Karen Parker, Program Planner, Permanency  Teresa Rodriguez, Program Planner, Permanency  Charlene Duffy, Program Planner, PermanencyJuvenile Probation, Placement Division:  Carl Kagel, Assistant Probation Division Chief  Jayme McKown, Supervising Probation Officer  Len Dozier, Senior Deputy Probation OfficerCDSS:  Daniel Wilson, Social Service Consultant, Children and Family Services Division, Outcomes & Accountability Bureau 8

California - Child and Family Services Review  Josephine Wilson, Associate Governmental Program Analyst, Children and Family Services Division, Outcomes & Accountability Bureau  Mary DeSouza, Social Service Consultant, Office of Child Abuse Prevention  Lisa Chavez, Associate Governmental Program Analyst, Office of Child Abuse Prevention The CSA Planning Process In December 2015, the consultants from California Department of Social Services (CDSS), Outcomes and Accountability Bureau and from the Office of Child Abuse Prevention (OCAP) met with Child Welfare’s Executive Leadership Team, Program Administration’s Management team, and Probation’s Placement Division Management team to review the process. Timelines were discussed and a plan to execute all steps in the CSA was laid out. Communication between CDSS and Sacramento County during the CSA was regular and the CDSS facilitated the Peer Review and participated in the large Stakeholders meeting. Participation of Core Representatives In late April 2016, the Core Team began meetings to plan the County Self Assessment (CSA) and Peer Review process. Joint probation, child welfare and California Department of Social Services (CDSS) meetings occurred monthly. Child welfare members also met weekly to discuss, organize, and implement all of the stages of the CSA, Peer Review Focus Group and Stakeholders meetings. During the course of the County Self-Assessment, many of the required stakeholders from child welfare, probation, service recipients, and county agency partners were fully engaged. CPS staff focus groups were held with the Child Welfare Executive Management Team (EMT) consisting of Division Managers, Program Managers, and Program Planners, and with CPS Supervisors, Social Workers, Family Services Workers, and Child Development Specialist workers. In addition, focus groups were held with Foster Parents, Relatives and Non Related Extended Family Members (NREFMs), Foster Youth, and Parents. Probation utilized internal focus groups to include Probation Officers, Senior Deputy Probation Officers, Supervising Probation Officers, foster youth and the parents of foster youth. All participants were surveyed regarding probation practices in regards to areas of strengths and weaknesses. There was a notable lack of involvement from parent representatives. A focus group was held on August 3, 2016 in which seven parents attended. However, the meeting ended early due to safety concerns for those present. Three additional parent focus groups were scheduled and cancelled due to safety or low enrollment. Birth parents were engaged several times by the core team, via county agency partners and electronic feedback options, but no one confirmed attendance and/or limited electronic responses were received. As a last attempt to engage this valued population, a fifth parent focus group was scheduled and 16 parents attended. A voicemail box was also set up to allow parents to provide verbal feedback. Stakeholder Feedback – Focus Groups Child Welfare Executive Management Team (EMT) Focus Group: The EMT focus group was held on June 27, 2016. Sacramento County data was provided depicting the County’s progress between the years 2012 and 2014 in comparison to the national standard. Questions were organized by five outcome measure areas, and EMT was separated into four different tables with each table asked to consider three main questions per measure: “What’s working well?” “What are the challenges/barriers?” and “What are the next steps?” Below are highlights from the EMT focus group: 1. Recurrence of maltreatment (S2) – Children with subsequent substantiated allegations during a 12-month period: 9

EMT expressed what is working well is implementation of Safety Organized Practice (SOP) and California - Child and Family Services Review progression of teaming practices to support families. Other strengths highlighted were practices utilized in Sacramento County, which include Structured Decision Making (SDM), responding to allegations thoroughly, supervisor staffing with social workers, supervisor reviews, and alignment of services. Additionally, services/programs mentioned included mental health services, i.e., Wraparound services, Flexible Integrated Treatment (FIT), and Residentially Based Services (RBS), Access to Community Care and Effectiveness Services and Support (ACCESS), Birth and Beyond home visitation program, relative supports (Lilliput, Sierra Forever Families), Informal Supervision, Early Intervention Drug Court (EIFDC), Celebrating Families, Public Health Nurses (PHNs), and Head Start Services. In regards to challenges and/or barriers, EMT stressed caseloads being consistently high and not enough staff support, as well as many new staff. Other issues were that teaming still is not implemented across the board, the tendency of staff to devise “cookie-cutter” case plan rather than tailoring the case plan to the needs of the family, and sometimes a narrow focus with families on specific issue identified versus looking at the whole system. Additionally, EMT reported there are issues with case history not thoroughly or correctly reviewed, case reviews being compliance- based instead of outcome-based with deeper quantitative measures, and inaccurate dispositions.2. Permanency in 12 months for children entering care (P1) – Percentage of children who discharged to permanency within 12 months of entering foster care: EMT conveyed what is working well are the following Sacramento County practices: Early case assignments and family engagement, Safety Organized Practice (SOP), collaboration and teaming, the Informal Supervision program, Early Intervention Family Drug Court (EIFDC) and Celebrating Families, the Child Placement Support Unit (CPSU), Kinship Unit, Team Decision Making (TDM) Meetings, Kinship Support Services Program (KSSP), Medical Neglect Review Team (MNRT), Family Resource Centers (FRC), Birth & Beyond Services, “Katie A.” screening/early referrals, family finding/permanency efforts with Permanency Case Reviews (PCRs), mental health service programs (WRAP, FIT, RBS), timely visitation, and better decisions at the beginning of the system regarding protective custody removals. Challenges and/or barriers included consistently high caseloads, staff turnover, newer workforce, workforce recruitment and retention, and Safety Organized Practice (SOP) not being fully implemented and practiced. Other issues identified were an inadequacy of thorough assessments and aftercare plans, and the focus on compliance of services instead of benefits and behavior changes. Also, court reports are often not timely, which causes continuances, and the court process itself is not timely. Additionally, TDMs being underutilized or dates/times unavailable to schedule timely; lack of availability of needed services for families especially with housing, limited crisis mental health services, cultural barriers and resources, lack of resources for high need youth (who have behavior/mental health issues, are chronic runaways, etc.), Commercially Sexually Exploited Children (CSEC) coming into the system with lack of resources and training for this population, lack of placements available for children, and the Kinship process being time consuming.3. Permanency in 12 months for children in care 24 months or more (P3) – Percentage of children still in care 24 months or more who discharged to permanency within the next 12 months: EMT voiced Sacramento practices that are working well include the implementation of Safety Organized Practice (SOP), placement with kin and non-related extended family members (NREFM), family finding/permanency efforts with Permanency Case Reviews (PCRs), early assignment/vertical 10

California - Child and Family Services Reviewcase management, teaming and youth engagement, Kinship assessments on an ongoing basis, relative awareness and searches, staying connected with parents, and second chance reunification. Challenges and/or barriers included difficult to manage workloads for staff, concurrent planning, complexity of cases, disproportionality in terms of race and ethnicity, lack of trauma training for families, lack of behavior/mental health services in the community, court continuances, and lack of resource families and group homes. 4. Re-entry to foster care (P4) – Percentage of children who were discharged within 12 months to reunification or guardianship and then had a re-entry into foster care within the next 12-months: EMT communicated Sacramento practices that are working well include the implementation of Safety Organized Practice (SOP), vertical case management, supervisor and social worker staffing with each other and with county counsel, placement with kin and non-related extended family members, family finding/permanency efforts with Permanency Case Reviews (PCRs), exit TDM meetings, aftercare planning, Birth & Beyond home visitation services, community resources, more financial resources for families (i.e., Kin-Gap), community partnerships (i.e., STARS), mental health service programs (WRAP, FIT, RBS), Family Service Worker visitation, Public Health Nurses (PHNs), Informal Supervision program, EIFDC and Dependency Drug Court. In regards to challenges and/or barriers, it was discussed better data is needed to assess Sacramento County’s utilization of Protective Emergency Placement Services (PEPS) and Voluntary placements in our work with families. This practice mitigates safety and risk factors when appropriate; however, the service skews data because it is not differentiated from regular placements. Other challenges included high caseloads, workforce changes and inexperienced workers, not enough special skills workers, lack of adequate assessments, Safety Organized Practice (SOP) not being fully implemented and practiced (including teaming), need for more natural supports and safety planning, better sustainable aftercare and support plans for families with good safety networks at closure, need for trauma informed training for parents and caregivers, under- utilizing Birth & Beyond home visitation program, lack of oversight with families in Dependent Supervision and not responding to cues earlier, lack of culturally focused services and possible disparity of services. 5. Placement stability (P5) – Rate of placement moves per day of children in care within a 12 month period: EMT felt what is working well are the following Sacramento County practices: Safety Organized Practice (SOP), collaboration and teaming, TDM meetings, mental health service programs (WRAP, FIT, RBS), Kinship assessments, relative and non-related extended family placements, relative supports (Lilliput, Sierra Forever Families), Approved Relative Caregiver (ARC) funding program, Family Service Workers (FSW) for transportation and visitation support, building relationships with foster family agencies, partnering with probation, maintaining children in their school or origin and placing siblings together, staffing psychosocial denial placements with program managers, pre- placement visits and placement matching, group home staffing, and recruitment for Lesbian, Gay, Bisexual, Transgender, Queer (LGBTQ) homes. In regards to challenges and/or barriers, it was discussed that data is skewed when a child arrives at the Child Placement Support Unit (CPSU) and is temporarily placed at the Children’s Receiving Home (CRH) pending placement matching. CRH is counted as a first placement episode; therefore, when the child moves to more permanent foster care, one placement move has already been11

counted. Other barriers included caseload challenges, doing placement work in isolation, foster California - Child and Family Services Review homes not prepared for level of youth needs, lack of trauma skills for foster homes, relatives and non-related extended family members (NREFMs), and it is too easy for foster homes to give a 7 day notice or give up on a child even for minor infractions. There is also a lack of homes available for sibling groups, teenagers, within school of origin, high need children, (i.e., runaways, behavior/mental health problems, medical/developmental issues, LGBTQ youth, CSEC, delinquency youth, etc.), and children are frequently negatively labeled. Additional challenges included background checks/waiver issues for relatives and non-related extended family members (NREFMs), lack of support systems for relative caregivers, foster family agencies and group homes not wanting to transport or facilitate visits, and lack of group homes in Sacramento County.CPS Supervisors Focus Group:On July 19, 2016, child welfare supervisors were invited to a one hour overview that explained the C-CFSR process and what it entails. Principal areas of Safety, Permanency, and Well-Being as related tofederal and state outcome measures were also discussed. On August 17, 2016, two separate focusgroups with supervisors were held, one in the morning consisting of 13 supervisors, and one in theafternoon consisting of 16 supervisors. In relation to four topics, service array, engagement, courtprocess, and work force development, supervisors were asked to consider three main questions pertopic area: “What’s working well?” “What are the challenges/barriers?” and “What are the next steps?”Supervisors reported a wide array of services available both internally and externally in the community;they stated services are easily accessible for families, and communication and collaboration withcommunity partners and service providers is mostly positive, helpful, and streamlined. Severalhighlighted services included the Birth and Beyond home visitation program, Specialized Treatment andRecovery Services (STARS) for substance abuse treatment and support, Early Intervention Drug Courtand Dependency Drug Court, Child ACCESS, Strategies for Change who provides multiple services withintheir agency, Hearts 4 Kids program, BEAR clinic, parenting classes, Team Decision Making Meetings(TDMs), Public Health Nurses, and Family Service Workers. Key challenges identified included lack ofculturally appropriate mental health services for children and parents, lack of services in the evening forworking parents, location of services being far away for some families, lack of specific services forfathers, housing and housing resources qualifications for families with low income with criminal orevictions histories, childcare, and the need for more foster care and adoptive homes. Some highlightednext step ideas were to negotiate with service providers to offer flexibility in their schedules, and toservice “dead zone” areas where accessibility to services is a barrier due to distance. It was suggestedSacramento County consider having “all inclusive” mobile service providers to serve families residing in“dead zone” areas.In relation to engagement, Supervisors reported there is an emphasis in Sacramento County on theimportance of engagement and improving the quality of engagement, and they felt Safety OrganizedPractice (SOP) is a promising approach toward enhancing engagement positively with families and thecommunity. Barriers to engagement were identified as high caseloads, the over use of texting instead oftelephone or face to face contact, the community’s negative perception of CPS, and long wait times oftwo to three weeks for a Team Decision Making Meeting (TDM) to be scheduled. Suggestions includedmore online capability instead of being paper based to save time, reinforcing SOP practice and utilizingmore SOP coaches, and community run “brown bag” meetings to discuss a variety of monthly topics.As to the Court process, supervisors reported specialized courts for extended foster care youth and CSECyouth are working well; Dependency Drug Court, especially the Early Intervention Family Drug Court,have a caring environment while providing consequences and accountability; and Court Officers providegood communication to social workers about what transpired during their court hearings. Keychallenges included staff not being trained timely about new law changes, the Court focusing on 12

California - Child and Family Services Reviewcompliance of service completion instead of behavior changes to enhance child safety, and CPS staff present in court, as well as families present, not being a priority and having to wait long hours to have their hearings heard. Furthermore, it was felt there was a lack of communication and respect from the Court and attorneys toward CPS staff, which has made the relationship feel adversarial and disparaging rather than collaborative and supportive. Next steps ideas included facilitating meetings with the Court to address what works and the challenges, to bring back “Coffee with the Court” to improve relationships, and to ensure information shared by the Court with management is filtered down to line staff. In regards to workforce development, supervisors reported feeling supported by management and upper management; they felt new technology assists in keeping them connected with their social worker teams and managers, and that there are generally opportunities to promote. They stated the hiring process for new hires was more streamlined and effective, with cohorts receiving extensive training prior to receiving a caseload. Additionally, peer trainers were identified as being an invaluable resource for new hires in providing “on the job” training, guidance, and support. Key challenges included significant staff turnover making the workforce overall less experienced including some staff who have promoted, long delays before hires from other departments are released, not having a good plan for social worker retention, performance evaluations not being completed due to the new system being difficult to learn and navigate, no peer trainers in Permanency programs, and an inequality of flexible schedules (9/80’s and 4/10’s) for all staff. Prominent next steps included promoting more mentoring programs at all levels, pay comparable to other counties, more flexible schedules (e.g., telecommuting, 9/80’s, 4/10’s), retention incentives, adding supervisors to new hire interview panels, peer trainers in all programs and peer trainers for supervisors, and more appreciation for staff and for staff to come together (e.g., barbeques, clubs, and events). For additional detailed information, please see Appendix A. CPS Social Worker Focus Group: Focus groups were held with Social Workers, Family Service Workers (FSW), and Child Development Specialists (CDS) on September 7, 2016, September 8, 2016, and September 13, 2016. A total of 42 workers participated. A brief overview of the C-CFSR process was provided and workers were asked to consider the three questions, “What’s working well?” “What are the challenges/barriers?” and “What are the next steps?” in relation to the topics of service array, engagement, court process, and work force development. Tables on the following pages show highlights/common themes regarding challenges/next steps discussed at social worker focus groups: Generally speaking, staff reported a variety of services available, both internally and externally in the community. Some highlighted services was access to Public Health Nurses and Senior Mental Health Counselors to assist social workers in the field in assessing medical and mental health issues with children and families. Staff also identified that Sacramento has a wealth of community resources available to provide to families, though it was noted that a few of the services are specific to a geographic area, so this was also a challenge that was noted. Another challenge that was highlighted was the seeming lack of appropriate foster homes for teenagers and the difficulty in getting some teens in care to be willing to go to a placement. All the groups suggested more effort and focus in the area of securing appropriate foster homes for all populations and for those homes to have more training around the needs of the youth. In regard to workforce, there were positive statements about more recent efforts to hire and train social workers in a cohort setting so there is a peer group to support each other as they enter the workforce and learn their jobs. While it was noted that the hiring and training efforts were good, there are still vacancies across the division which make caseloads for those working higher than desired to provide the level of services necessary. The suggestions in this area were around more program specific training and continuing to hire staff to bring caseloads down. There was also a lot of13

support for having Peer Mentors (senior staff) who know the program and can be assigned as a peer California - Child and Family Services Reviewtrainer in program for all new staff.In reporting on our court involvement, there is an understanding and appreciation for the accountabilityrole the court plays on behalf of the children and families served. Some staff reported that they havehad great court experiences and attribute this to good communication. As with any system, challengeswere also reported around the rigid structure and timelines inherent in the court system and that socialworkers can feel like they are not an equal or valued partner in some instances. It was also noted as achallenge that the families do not always understand the process or what occurs in court. Staffencouraged ongoing communication and opportunities to build relationships between workers andcourt staff, as well as enhancing parent orientations to help them better understand the system.For more detailed information, please see Appendix B.Foster Parent Focus GroupA focus group was held with 29 foster parents on July 20, 2016. They were asked questions pertaining toagency support, service array, caretaker involvement, well-being of foster youth, retention, andrecruitment of foster parents.What’s Working Well:Foster parents felt what was working well included special needs funding, public health nurses,Individualized Education Programs (IEP), mental health services for children, Wellness Recovery ActionPlan (WRAP) services, Alta Regional support, and transportation assistance. Foster parents stated somesocial workers really care about their job and are responsive and helpful. Additionally, the current FosterParent Liaison is responsive in providing information and connecting foster parents with supervisorswhen needed.What’s Not Working Well:Foster parents voiced concerns about not being able to contact their social workers; social workers notreturning their calls, social workers’ voicemails being full, and the Worker of the Day (WOD) notanswering their telephone. They mentioned when they spoke with the supervisor, they felt thesupervisor did not listen, appeared to not care and defended the social worker. Also, they felt their timeis not always respected, in that social workers arrive late for home visits or Family Service Workers arelate bringing children for placement. Other challenges included not receiving Medi-Cal cards for severalmonths, Family Service Workers not having business cards, and not knowing tips for how to accessservices such as the eligibility worker for Medi-Cal cards.Foster parents also expressed their concern that their input is not obtained when changes to visits aremade, and they do not receive notice when changes occur. Also, when they have concerns regarding achild’s condition after returning from an unsupervised visit, the social worker does not do anythingand/or seems to support the parent’s rights more than the child’s. Furthermore, they often receivechildren from the Child Placement Support Unit (CPSU) with minimal information including importantmedical needs, and Child Folders not being received or containing incomplete or outdated information.Additionally, they have long hours of wait time at court, but they feel that if they do not go to court it isdifficult to receive information from social workers about what transpired.Next Steps:Foster parents requested social workers provide their email addresses as another avenue tocommunicate and that Family Service Workers are provided with business cards. They would like forms 14

California - Child and Family Services Reviewto be electronic or on line and up to date, to have direct deposit as an option, and to be able to look up court dates on line. They also requested a method be arranged for foster parents to receive money for clothing at time of placement for children who come with nothing. They asked to be provided with comprehensive up to date information about a child being placed with them; that they receive 48 hour notification of any changes to visitation schedules, and that a tracking system is developed for children coming back into care so efforts can be made to place with a previous foster family to support child wellbeing. Additionally, they desired to have an ongoing support group where they can discuss ways to support one another and also voice concerns to CPS staff members present to improve working relationships and solve problems. Relatives and Non Related Extended Family Members (NREFMs) Focus Group A focus group was held with relatives and Non Related Extended Family Members (NREFMs) on September 6, 2016. 8 individuals attended the focus group. They were asked to consider the three questions, “What’s working well?” “What are the challenges/barriers?” and “What are the next steps?” in relation to the topics of service array, engagement, court process, and work force development. What’s Working Well: Relatives/NREFMs reported that mental health services for children and parent-child interaction therapy (PCIT) are set up quickly. Also, Kinship Social Workers are good at communicating the process of being a caregiver. They remarked that Public Health Nurses are helpful and an asset, and added that some social workers maintain excellent communication with caregivers. What’s Not Working Well: In regards to challenges/barriers, Relatives/NREFMs felt that information about children, including lack of paperwork verifying child’s placement or treatment authorizations was not provided timely. Also, there is a lack of resources for relatives/NREFMs; no emotional, financial or educational support for them to assist in the challenges, and no daycare or respite assistance. Furthermore, there are no parenting resources for caregivers or that information is not provided. Relatives/NREFMs also felt that sometimes services for children are delayed because of no Medi-Cal or referrals are not made timely, especially counseling. They stated social workers’ visits are too brief due to high caseloads, and there is not enough time for social workers to establish strong relationships with them or the children. Also, social workers and supervisors do not return phone calls; there is high social worker turnover; relatives/NREFMs are not informed when there is a change in social workers, and new social workers take a long time to familiarize themselves with the case. Additionally, the knowledge base of social workers is limited and workers are not educated regarding resources available to caregivers. Other concerns included their feeling that social workers focus and devote their energy on parents instead of what is in the child’s best interest, and that their feedback is not sought regarding children’s well-being. Also, they are not part of decisions and are not well informed by social workers, the court, or attorneys. Spanish speaking caregivers stated their cases are assigned social workers that cannot speak Spanish, or social workers do not use interpreters for monthly visits or contacts, and only communicate with the child and not them. Furthermore, relatives/NREFMs felt that educational rights need to go to them early in the case when there are likely to be educational issues and when parents are not engaged. They also felt that permanency is delayed because services are continued when participation is poor by parents. Next Steps: Relatives/NREFMs requested better written communication (child’s placement folder, placement agreements, authorization to treat, Medi-Cal card or number, Health Education Passport, etc.) and15

better verbal communication between social workers and caregivers where exchange is mutual, not one California - Child and Family Services Reviewsided. Also, they asked that Family Service Workers communicate better with caretakers and not waituntil caretakers’ contact them about whether visits will or will not take place.Relatives/NREFMs stated social workers need training or education on what information can be sharedwith caregivers to allow for teaming to work well - sharing information about the case status andlikelihood of reunification. Also, information about prudent parent standard needs to be discussed withcaregivers to provide guidance as well as a list of resources for services, including parenting classes,support groups if available, tutoring for children, respite care, daycare resources, and generalinformation on how to navigate the system and access resources. It was suggested this could occur in astandardized orientation for caregivers.Relatives/NREFMs recommended that caregivers have educational rights to ensure proper educationalassessment and services are set up. They also asked that children’s attorneys maintain consistentcontact with caregivers to ensure children’s best interests are represented. Further, they requestedmore bilingual social workers are hired or to ensure social workers are required to use interpreterswhen caregivers do not speak English.Relatives/NREFMs stated they wished that social worker caseloads could be lowered and efforts madefor retention so that social workers could spend more time with caregivers and children to better meettheir needs. They added they would like to have a Department/Relative liaison to assist caregivers whenneeds do not necessarily require a social worker to get involved (i.e., getting authorizations fortreatment, Medi-Cal information, etc.).Foster Youth Focus GroupA focus group was held with 14 foster youth on August 25, 2016. They were asked to consider the threequestions, “What’s working well?” “What are the challenges/barriers?” and “What are the next steps?”in relation to the topics of service array, engagement, court process, and work force development.What’s Working Well:Foster youth reported the following worked well: Court Appointed Special Advocates (CASA), AssemblyBill 12 (extended foster care up to age 21), Independent Living Program, Children’s Law Center (CLC),mentoring program, Wonder Inc., Stanford Youth Solutions, Therapeutic Behavioral Services (TBS),WellSpace Health (formally The Effort), behavioral counseling, family counseling, Sierra Forever Familiesand their group called Youth Speaking Out, emancipation meetings, and workers who areunderstanding, open to listening and “treat us as individuals”.What’s Not Working Well:Negative consequences for youth included not getting services and resources they needed (timely or atall), not being informed, and not being respected by workers. It was mentioned it is difficult and cantake several months or more to obtain birth certificates, social security cards, Medi-Cal cards, and/orproof of insurance, etc… and often they learn paperwork is lost, which delays the process further. Also,they felt they are not receiving enough money to buy necessities; there are delays in getting securitydeposits for independent living arrangements, and if placed out of county (e.g., Placerville) they cannotaccess the Independent Living Program or other needed services.A common theme was a feeling of under engagement from their social worker; that there was a lack ofcommunication from their worker and/or their worker was hard to get a hold of. They said their socialworker was not seeing them regularly or calling or emailing. They described receiving mixed messagesfrom their worker; their worker being “fake” in that they told them one thing and then told their 16

California - Child and Family Services Reviewattorney something else; another promised to see the youth twice a month if they did not leave placement without permission and then did not follow through; and that workers do not communicate well, do not listen, and twist their words around inaccurately reflecting what they say in court reports. They felt social workers had a lack of understanding of the history of their case and write court reports about them without taking the time to know them. They also expressed dissatisfaction with delays of a week to a month in receiving information back from social workers, and once they turned eighteen there was not much engagement from their social worker. Youth talked about visitation with their family being cut off quickly and being placed “anywhere” without consideration for matching and safety, sometimes resulting in a poor placement or dangerous situation. They felt Team Decision Making (TDM) meetings were “annoying”; they did not want to wait seven days to move placements; they did not understand the purpose of a TDM, and expressed that sometimes they did not want to talk about things in front of everyone. They said the Transitional Independent Living Program (TILP) is good in theory but it does not have others identified (support system) to help them reach their goals, and often their name is the only person listed. Youth mentioned wanting to see their workers more often with longer and more meaningful contact. Youth felt that high caseloads and work demands negatively impacted the quality of service delivery and social worker engagement. They reported they have had interns instead of social workers and switched social workers many times, which does not allow time to build trust and form a relationship. Youth were concerned about lack of court involvement/information provided to them. They felt the court listens to social workers more than them and that the child’s voice is not heard or considered. They shared that going to court sometimes felt “pointless”, in that they had to be there at 8:00 a.m. but their case was not heard until 11:00 a.m.; they only saw their attorney at court, did not feel they had time to share their concerns, and felt rushed. They added that terminology in court is not child friendly and sometimes they did not know why they were at court or what would be said about them in the court report or at the court hearing. Next Steps: Foster youth were focused on services being more accessible and improving timeliness and thoroughness of services. They felt the Independent Living Program should be mandatory and begin sooner, and that it should include more relevant interactive training with real life scenarios. They mentioned it would be valuable to receive skills training regarding simple tasks such as “how to get a driver’s license”. They also requested their social worker email or text them regarding upcoming events, services, etc… and ask them how they would like to receive information (e.g., in person, telephone call, text, email, etc…). Foster youth shared they would like social workers to play a more interactive role in their lives and not treat them like “kids”, be condescending, or pretend to be their friends. They asked that workers be more polite, stay true to their word, not assume youth know or do not know, take the time to build rapport and bond with them, be more involved, and listen more. They stated they have a lot of services and do not want to be pushed into services they do not want (e.g., counseling) or into taking medication, etc… Also, they requested social workers not read their file until they have met them and/or not judge them based on what they read in their file until they have gotten to know them. They further requested social workers not look to their foster parent first to determine what a youth needs or to assess how they are doing. Foster youth were also interested in more training and education for the CPS workforce, specifically on building rapport with youths, engagement, and services and incentives available for youth. They also17

wanted social workers to be trained on working with specific populations, i.e., Commercially Sexually California - Child and Family Services ReviewExploited Children (CSEC). Their wish was for social workers to have manageable caseloads of 15-20children to allow time to do good work, and to be able to have the same social worker so they candevelop a relationship.In regards to court involvement, youth suggested a youth coach/peer be available to explain what isbeing said in court and to answer the youth’s questions because sometimes language in court is difficultto interpret. It was also suggested the Court be more child friendly during the proceedings and thatchildren be allowed to speak to the judge. Additionally, they would like social workers and attorneys tocommunicate more and for social workers to portray them accurately in court reports.Parent Focus GroupA focus group was attempted with parents on August 30, 2016. Seven parents attended the focus group.Minimal information was gathered, as the meeting was cancelled due to safety reasons. However,parents did provide the following feedback regarding service array:What’s Working Well:Parents felt that there are some good service programs including Community for Peace, which they feltwas the best domestic violence program in Sacramento County because it offered an array of servicesincluding one on one counseling, parenting, youth groups, and crisis counselors that go out with CitrusHeights Police on domestic violence calls. They also named Birth and Beyond for their parenting classesand in home parenting program, Specialized Treatment and Recovery Services (STARS), Strategies forChange alcohol and other drug services, and Cornerstone for Recovery anger management program whohas a provider that works with couples to strengthen their relationship.What’s Not Working Well:Parents noted the following as challenges/barriers: Community for Peace is good for women/victims ofdomestic violence but does not service the entire family because they do not have programs forbatterers and are not for families that want to stay together. There is lack of services for fathers ingeneral, and the only domestic violence service for fathers is Man Alive, which was not very good. Theyfelt that Women Escaping a Violent Environment (WEAVE) was not a useful domestic violence programbecause they only have group classes and lack the service array Community for Peace offers.Additionally, they stated there is a lack of housing resources in Sacramento County and strict criteria forqualification.Next Steps:Next steps for parents included more resources for housing especially after their case closes, domesticviolence classes for men similar to the DIVA program at Community for Peace, and for CPS to havesimilar crisis counselors as at Community for Peace who could go out to homes during law enforcementdomestic violence calls to work with victims before opening a referral.Attempts were also made to have parent focus groups with two existing Family Resource Center groups,on September 29, 2016 with “Parent Leaders” and on October 3, 2016 with the “Parent Cabinet”;however, both meetings were cancelled due to low attendance.A successful parent focus group was held at Specialized Treatment and Recovery Services (STARS) onOctober 14, 2016 with parents in an aftercare group called “Cross Talk”. Parents in this group hadcompleted substance abuse treatment and Drug Court. The group consisted of 16 parents who wereasked to consider “What’s working well?” and “What are the challenges/barriers?” in relation to the 18

California - Child and Family Services Reviewtopics of service array, engagement, court process, and work force development. Only an hour’s time was allotted to this group effort. Below is the parents’ feedback: What’s Working Well: Some parents reported having social workers who consistently answer their telephone calls and text messages and who are always available to provide support, guidance, and assistance. They said these social workers were honest and did not “sugar coat” their situation; they treated them with respect, were positive, and gave “kudos” for good work, progress, and accomplishments. They also felt they were “on the same page”, in that these social workers listened, considered their specific situation and needs, and teamed with them in a strength based and solution focused manner that facilitated their successful reunification with their children. Parents also reported that having one worker for consistency was a plus and made a big difference because they were able to develop a relationship and their worker had a thorough understanding their case. Family Service Workers were also praised as being helpful and supportive, and parents stated Dependency Drug Court was “very supportive”. Services that were highlighted as beneficial included Bridges and Strategies for Change whom parents said have good programs for domestic violence and substance abuse, and “Rooms for Dads”, which is a good program for fathers. Other positives including having observed visits extended to overnight visits to help parents prepare for the return home of their child, and social workers working with parents to personally tailor their services (i.e., allowing outpatient treatment versus residential) for a better fit. It was also mentioned that a tribe intervening for Native American children is positive because it keeps children out of the CPS system. What’s Not Working Well: Parents described having difficulty with social workers calling them back and expressed that lines of communication are often poor between social workers and parents. They felt some social workers lied and were manipulative, and that the parent’s side of the story or opinion did not matter. They talked about there being no or little engagement from social workers; social workers being threatening, rude, insensitive, and judgmental, and not respecting their time (e.g., showing up late). A parent shared her visitation was changed from unsupervised to supervised and she was informed through text message instead of a telephone call and discussion. Parents felt there was also a lack of honesty with social workers, in that for example, a worker promised to return a child to a parent if he was compliant for 90 days, and then did not follow through. In addition, they said social workers will speak to caretakers or others about their concerns regarding a parent instead of going directly to the parent, which feels disrespectful. A common theme was parents feeling the system is set up for them to fail; they are handed a “very big case plan” without involving them in the process, and the plan is not personal or tailored to their needs. They expressed feeling overwhelmed with services, and receiving minimal to no guidance or support. They also felt the system is compliance driven; focused on going “through the hoops” rather than on improvements, achievements, and positive behavior changes. They also discussed being threatened that reunification would not occur if they did not satisfy what they felt was unfair criteria (i.e., obtaining a two bedroom apartment instead of a one bedroom apartment). Parents discussed that because the CPS system is so heavily services driven and parents are expected to complete a large array of services, it takes a long time for parents to reunify. This results in a significant loss of bonding or no bonding with their children, as a few hours a week of visitation does not foster much of a connection, especially with newborns and young children. Additionally, since they have not parented for a long while, or as with a newborn, not at all, it is extremely difficult to suddenly be19

expected parent when their child or children are returned with no transition plan or supports put in California - Child and Family Services Reviewplace to nurture success. This is especially challenging if they have a special needs child.Parents talked about being compliant with their case plan but their visitation not being moved fromsupervised to unsupervised because social workers have set schedules and time periods of how theybelieve supervised visitation should transition to unsupervised, instead of assessing and consideringdifferences in individual achievement. Also, if a foster parent or other caregiver is unwilling to transportchildren to visits, there can be a delay in parents’ visits moving to the next level (from supervised tounsupervised). In addition, visits sometimes revert back from unsupervised to supervised due to thesocial worker’s own agenda and unwillingness to work with the family system and supports.Parents discussed that Lesbian, Gay, Bi-Sexual, Transgender, Queer (LGBTQ) relationships and LGBTQmarriages are not taken seriously, and that LGBTQ parents are discriminated by the whole CPS system,including the Court. They also felt that husbands are discriminated against because they are notbiological fathers, in that they are not considered or provided with services. Furthermore, they said non-offending parents are made to complete a large array of services similar to the offending parent if theywant to have custody of their child, and if they reside out of county, they are directed to commute toSacramento County to comply with services or else risk non-reunification. Additionally, they reportedthere is a lack of services for fathers in general, and there are no domestic violence services for abusedmen.Parents discussed that caseloads for social workers are “very heavy”, which causes delays in services anddelays in visitation moving to unsupervised. They reported there is a high turnover of social workers;one parent said she had six different social workers in less than a year and another parent said she hadthree different social workers in a year. Additionally, parents reported that transfer of knowledge oftheir case did not occur between social workers when changes of case assignment occurred.An important issue for parents was lack of housing resources. They felt this was a “huge problem”because they were told they could not have their children back until they secured appropriate housing.Another important issue was lack of child care services in Sacramento County. Some parents stated theywere informed about Child Action for child care assistance but were not provided with the paperwork orassistance to enroll or be placed on the program’s waiting list.In regards to the Court process, parents felt that even though everyone’s situation varies, the Courttreats everyone the same with little regard for individual differences. They reported they were notallowed to speak at court during their hearing, and felt that no one was interested or willing to hear theparent’s side of the story. They also reported that court reports in general are unfair, one-sided, andnegative, with nothing positive contained in them about parents. They shared there are sometimesdelays in reunification if the Court continues the matter repeatedly, or in one parent’s case, theJurisdiction/Dispositional Hearing was not completed prior to the six month review hearing and therecommendation in the six month Status Review report was return home.Parents discussed they felt it was unfair to require a parent to start completely over in services if theyhad a false positive drug test that was not their fault, or if they had a single relapse. They felt a morereasonable penalty should be given rather than delaying reunification by several or more months.Parents stated they felt the Kinship program that approves relatives and non relative extended familymembers (NREFM) needs to “be more on top of it”. They said Kinship workers are sometimesargumentative and unwilling to be flexible about home visits and their time. They related Kinship losespaperwork, which delays the process, and it takes too many months for relatives/NREFM approvals. 20

California - Child and Family Services ReviewParents involved with the Informal Supervision (IS) program shared there are a lack of bus passes available in this program, which impacts their ability to complete their case plan services. Also, a parent stated she was told she needed residential treatment; however, there were no beds available in Sacramento County. She located a bed in Placer County, and because she went to residential treatment outside of Sacramento, her case was sent to Court. Another parent stated that in treatment programs, IS clients and court clients are mixed, and when they communicate, it is learned that IS parents have less services to complete than court parents even though their situations are similar (i.e., both had children born with drugs in their system). This creates a belief that there is unfairness and prejudice in the CPS system. Additional concerns brought up by parents included that when they share with a social worker their valid worry about their children’s safety in a caretaker’s home, the social worker who is a mandated reporter, instead of opening a referral for investigation, telephones the caretaker directly and asks the caretaker to address the issue (i.e., clean their home). This feels unfair and unethical, and when they complain to the supervisor, they are disregarded because they are labeled an “addict”, etc… Furthermore, they feel they are held to higher standards than caretakers. If their child is hit by other children in placement or injured in placement, the foster parent is not held accountable; however, if that happened in the parent’s home, they would be charged with neglect. Next Steps: Important for parents was having a consistent social worker who returns their calls and is assessable. They suggested CPS recruit social workers who have similar life experiences and backgrounds as CPS parents so they will have more empathy. They asked that social workers let parents know clearly what needs to happen to reunify or be successful. They stated CPS needs family programs so that families can be together in treatment (i.e., family residential treatment). Also, more programs and services are needed for single fathers especially programs for fathers that allow them to take their children with them like they do for mothers, and that transitional housing be available for father’s and their children. They stated CPS should have a housing program and child care program. They felt strongly CPS should create case plans with the parent and give consideration to not overwhelming parents with multiple services, and that CPS social workers should be more considerate and gentle especially at the beginning when setting up case plan services. Stakeholder Feedback Sacramento County held two separate large stakeholder meetings, which included core team members and child welfare and probation representatives. Out of approximately 218 agency/community organizations invited, 53.2% participated. The first stakeholder meeting was held the morning of September 14, 2016 and was comprised of 78 participants (15 child welfare representatives, 1 probation representative, and 62 agency/community organization representatives). The second stakeholder meeting was held the afternoon of September 15, 2016 and was comprised of 70 participants (16 child welfare representatives, 1 probation representative, and 54 agency/community organization representatives). Participants signed an attendance sheet; however, not all agency/community organization participants noted their organization. The table below reflects participating agencies/community organizations that included their affiliation on the attendance sheet.21

Stake Holder MeetingsAgency/Community Organizations noted on Attendance SheetSeptember 14, 2016 September 15, 2016Alcohol and Drug Advisory Board Affordable Housing and Educational ServicesAlta California Regional Center (ALTA) American River CollegeAnother Choice Another Chance Child Abuse Prevention CouncilBehavior Health Services – Children Mental Health Children and Family FuturesBetter Life Children’s Services Children NowCasa Children’s Law CenterChild Abuse Prevention Counsel Children’s Receiving HomeChildren’s Receiving Home of Sacramento Court Appointed Special Advocates (CASA)City of Sacramento Police Department Department of Human Assistance (DHA)County Counsel Juvenile Court BenchDHA La Familia Counseling CenterHope for Health Families Counseling Margaret Beryl Beauford, TherapistKoinonia Family Services Preventative Medicine Medical Doctor SpecialistJuvenile Court Bench River Oak Center for ChildrenLesbian, Gay, Bi-Sexual, Transgender (LGBT) Sacramento Children’s HomeCommunity CenterLilliput Children’s Services Sacramento Sheriff’s Department Special InvestigationsMu’eed Family Agency Sacramento County Office of Education (SCOE)Roberts Community Center (CIC) Stanford Youth SolutionsSacramento Unified School District (SCUSD) – Specialized Treatment and Recovery ServicesStreet Team (STARS)Sierra Forever Families Strategies for ChangeStanford Youth Solutions VIRTIS, IncThe Cutting Edge Journey Welcome Home Foster Family AgencyTribal Economic and Social Solutions AgencyTrue North ProjectUplift Family ServicesEach stakeholder meeting was facilitated by the Northern California Regional Training Academy and California - Child and Family Services Reviewconsisted of an overview of the C-CFSR process and principal areas of Safety, Permanency, and Well-Being as related to federal and state outcome measures. Sacramento County data was provideddepicting the County’s progress between the years 2010 and 2015 in comparison to the nationalstandard. Mini focus group tables were then organized by the following outcome areas:1. Recurrence of maltreatment (S2): Children with subsequent substantiated allegations during a 12-month period.2. Re-entry to foster care (P4): Percentage of children who were discharged within 12 months to reunification or guardianship and then had a re-entry into foster care within the next 12- months.3. Placement stability (P5): Rate of placement moves per day of children in care within a 12 month period.4. General questions: Collaboration, service array, training, past and future improvements, and poverty. 22

California - Child and Family Services ReviewEach table was provided with a lap top computer and questions to guide the discussion, and each table was asked to hold no more than ten participants. Participants were asked to choose a facilitator and note taker, and during the course of the meeting participants were able to pick two focus areas on which to provide feedback. The tables on the following pages summarize the highlights from the stakeholder meetings in regards to the challenges and suggestions for improvement in relation to the four outcome measures above. Recurrence of Maltreatment Challenges  It is not easy for children and families in isolated geographical areas of the county to access services because transportation is a big issue.  Workloads are a barrier. CPS appears to be overworked and stressed at times. They may not have the resources to meaningfully engage in collaborative contact.  Family’s issues (e.g., recurring domestic violence, substance abuse, mental health, unemployment, low social economic status, limited education, etc.) not fully addressed.  Families remaining in the same community/geographical area with continued access and/or exposure to situations that make them vulnerable to same behaviors (i.e., liquor store, peers, etc.)  Parents are unable to navigate or access the informal system.  Parent’s family support networks burn out and family becomes more isolated.  Referrals are timely; however, no coaching, guidance, or assistance is offered to overwhelmed parents on what the services are for, how to select them, or how to get started. Parents are sometimes just provided a list.  Chronic developmental or mental health issues are likely to resurface, and relapse is always a possibility with substance abuse and mental health issues – need better aftercare and safety plans.  Barriers to parent engagement in services – conflict and stigma related to treatment, accessibility, and lack of services available to families without court supervision.  Centralization of referral process for services is a barrier.  Supports only available to parents who present with a serious mental illness. Services are needed to support parents with adjustments to recovery.  Barrier to engagement (e.g., domestic violence is recurring).  Insurance issues/Medi-Cal.  Services that end with end of court supervision.  Lack of culturally sensitive services – too much of a “one size fits all” approach to parents and families.  Need to overcome distrust and fear, and present ways that are supportive and non-stigmatizing.  CPS needs to do more public outreach and community engagement, providing information on programs and goals.  Housing needs.  Employment needs.23

Recurrence of Maltreatment California - Child and Family Services Review Suggestions for Improvement Have a CPS “Uber” to aide families in isolated geographical areas of the county and/or families with transportation challenges. Have a treatment “Uber” to ensure services in all geographical areas of the county. Engage Community Partners via census data. Improve exchange of information between agencies; FFA agencies have intimate information about children, parents and foster parents, but are rarely asked for in-put in decision-making. Aftercare coach/mentor would assist parents to implement everything they have learned in their classes. Create more on-going support for reunification – community based versus CPS. Dig deep to evaluate the family situation, and then make recommendation for services. More visibility, outreach, and engagement. Safety networks. More teaming and collaboration. Trauma informed culturally and linguistically relevant services. Have other community based agencies take the lead in offering support. Most effective services: Strengthening families, access to services that are culturally appropriate, supportive, and positive in approach. Respite services. Resource parents. Early/Preventative linkage to community providers. Re-Entry Challenges Factors that brought child into care not completely addressed or resurfaced after reunification services were terminated. Reunification viewed as “the success”—focus not always on the continued success following reunification. Families fear support gone after reunification. Families reunified too quickly without all services provided. Social isolation of families; ensure families have viable support networks. Failure to link families to aftercare/connection to local resources; lack of depth of supportive resources after case closure. Parent’s lack of understanding what is required (paperwork, classes, etc.). Reunification before birth parent is ready. Child Care is a challenge for families and may lead to re-entry. Changes in family circumstances/life changes (financial, job loss, housing instability, family member disappearance, onset of mental health issues, etc.) are challenges for families and may lead to re- entry. To outside providers, CPS or Court decisions often seem arbitrary—sometimes it seems like “luck of the draw”, dependent on what SW you’re assigned to. Too many discussions/decisions made without parental involvement. 24

California - Child and Family Services Review Re-Entry Suggestions for Improvement  Ensure Team Decision Making Meetings (TDMs) occur prior to overnight visits and exiting transition plans.  Decrease caseloads to increase availability of social workers for better provision of services/engagement with families.  Culturally sensitive and compassionate supports to educate and engage families.  Improve communication between agencies.  Need priorities identified for CPS and courts when making reunification determination.  Need more safety planning.  Move from compliance (case plan completed) to behaviorally based (behaviors are demonstrating readiness) case plans.  Increase Teaming/Engagement of community providers with historical information on family.  Ensure community based organizations that understand cultural needs of families are in place.  Make parents a part of initial conversations.  Safety Organized Practice initiatives will improve outcomes for families and children and lessen re- entry rates.  More interaction between resource family and birth parents.  Team Meetings—bring team that previously worked with family back together if/when a new referral for the family is received.  Use home caregivers willing to mentor parents.  Have community check-ins with family or extended family. Placement Stability Challenges  Insufficient collaboration with Behavioral Health, outside agencies, and CPS.  Collaboration is a want, but not always implemented.  Returning home too soon.  Expectations on children in group care may be too high and set youth up for failure. Cannot step down in punitive system if do not meet behavioral goals.  Waiting too long for mental health treatment.  Difficult for youth who has been seeing a counselor for a long time to make a change if they move, or if therapist moves. Difficult for youth to start again.  Medi-Cal turned off when law enforcement detains child at Youth Detention Facility (YDF).  No one in County advocating for system of care with Behavioral Health due to fragmentation of system.  Kinship assessment is too slow.  Sometimes foster parents feel like an available bed but not active part of decision-making for children.  Overuse of 7-day notice – used out of frustration or for other reasons. Better training for families is needed.25

Placement Stability California - Child and Family Services Review Suggestions for Improvement TDMs supposed to stabilize placements; ensure they are occurring and plans are sustainable. Acuity of needs increasing – need services that match those needs. System needs to collaborate in identification and sharing of resources. Build more supportive service arrays. More imbedded services with the family. Services that meet the needs of the family, not provision of services at the convenience of the system. Teaming is critical for all involved. Team approach is best. Assessments for placement need to be individualized in order to meet interests of the child. Decrease social worker caseloads. Workers have high caseloads – this impacts their ability to thoroughly address concerns that arise in placement in a timely manner. Make Children’s System of Care similar to Nevada and Placer counties (better integrated system). Child specific recruiting of foster families/better matching of family and child. Market recruitment efforts less on financial piece versus outcomes to be achieved (i.e., having a positive impact on a child’s life). Counselor available to speak with foster parent/child to help resolve issues threatening placement. Stop talking about “beds” – they are placements. Core supports and service delivery prior to RFA approval (allows support during initial 90 days of placement). Resource Development and recruitment. Support and preparation of caregivers. Training on what resources are available. Provide support services before there is an issue. More comprehensive training for foster parents. Need Sacramento County Placement Summit, to bring all people together to change things and get more foster families on board. Peer support amongst Foster Parents. Every agency needs to become an expert on trauma informed practice and train foster parents/relative care providers. Have a crisis number to call when social worker is unavailable and caretaker needs help. 26

California - Child and Family Services Review General questions Collaboration, service array, training, past and future improvements, and poverty Challenges  Lack of information regarding where youth are getting their services, and concerns about lack of alignment regarding services to youth. Outside collaborators are unaware of what services youth are entitled .  Mental Health providers do not always see what services are available for youth coming into care.  Lack of communication and collaborations between county agencies for data sharing or other ways to serve shared populations.  Services exist but sometimes accessibility and linkage is wanting.  Housing needed for all: Single, families, men and children, sober living, CSEC, foster relatives/community caregivers.  Treatment for teens.  AOD, Sex, and Domestic Violence education in the schools (One Semester)  Transportation is a challenge for families.  There is not the capacity to meet the need in many of the services (like Birth and Beyond) that have proven successful.  Services for youth with disabilities.  Language and geography barriers.  Lack of access to dental treatment.  Lack of youth buy-in to services that are provided.  Communication/cultural differences with the population being served and perceived biases by the youth due to their culture are barriers.  Big deficit in services for LGBTQ community and their families.  Caretakers lack training in trauma informed care (need follow up and more depth training, not just Basic 101).  Lack of housing stability.  Programs and services constantly changing/moving/closing.27

General questions Collaboration, service array, training, past and future improvements, and poverty Suggestions for Improvement Have a shared database between law enforcement, CPS, and Community for Peace. Increase stakeholder meetings and include a wider range of providers and community based organizations. Child Care with varied hours. Better access to therapy. Aftercare Increase in cultural awareness and sensitivity trainings and education to assist with cultural differences with the population being served. Cross Training between groups to gain common language/knowledge. Create a better system to get training information out to all—webinars, services, resources, etc. include youth in training, planning, and resources. More nutrition trainings, especially with families. County is looking at partnering with local farms to teach healthier lifestyles. Increase education/training for trauma informed care. more satellites and mobile services to go to community centers or libraries, and increase service accessibility. More collaboration and trainings that include multi-disciplinary agendas. engage paraprofessionals in needed services, like Medi-Cal Dental Extended Foster Care with extended medical benefits. Improvement in the service culture, i.e., “I don’t know the answer, but I’ll find it.” More transparency. Co-locating staff in multiple agencies. Trauma informed care. Consistency across the board with Law Enforcement regarding response to Domestic Violence Issues. Really validate the foster families and all the work they do, to help with retention/recruitment. Look at communities where services are needed, and begin recruitment (Rancho Cordova, East Sacramento, Del Paso Heights. Knowledge of available programs/services out of date.Probation Officer Focus Group: California - Child and Family Services ReviewA questionnaire was provided to Probation Officers during September, 2016. A total of eight officersparticipated. A brief overview of the C-CFSR process was provided and workers were asked to considera myriad of questions regarding Placement. Tables on the following pages show highlights/commonthemes regarding challenges/next steps discussed at social worker focus groups: Probation Officer Focus Group Service Array Challenges/Next Steps Job is stressful, complicated, high learning  Safe Measures not user friendly.curve, travel.  Funding for AB12 Lack of communication between agencies.  Not enough training – placement training Wrap wait times. officer Not enough group homes. 28

 Not enough time in the day Probation Officer Focus Group  Caseloads are regional Engagement Challenges/Next Steps  High caseload turnover  High caseloads  Too much paperwork Probation Focus Groups Placement Focus Group: A questionnaire was given to eight probationers in placement in September, 2016. They were asked to consider a myriad of questions in relation to the topics of service array, engagement, court process, and placement. What’s Working Well: Placement minors reported the placement officers meet with them regularly and are available to be contacted by telephone. Placement minors reported their placement officers were very helpful in helping them understand the placement process and guided them through their placement commitment. Minors felt they had involvement in their case plan process. What’s Not Working Well: Placement minors reported they would like to spend even more time with their probation officers then the monthly visits. They would also like to have more input into the selection process of their placement program. Placement minors mentioned wanting to attend public schools, participate in more athletics and have better after care programs. A bigger concern of the minors was for better care of their property throughout the placement process by both probation and the placement programs. Placement Parent Focus Group: A placement parent questionnaire was given to eight placement parents in September and October, 2016. They were asked questions pertaining to agency support, service array, caretaker involvement, well-being of foster youth, retention, and recruitment of foster parents.California - Child and Family Services Review What’s Working Well: Probationer parents felt Probation Placement Officers were compassionate, listened, kept them informed and had good communication. Regular contact either in person or by telephone was a positive response by those parents questioned. What’s Not Working Well: Probationer parents voiced concerns about not being able to get the Court to understand the needs of their child. At times there is a disparity between what the Court and Public Defenders Office and the parents feel are the needs of the minor. There was also concern the Court and Probation is not hard enough or strict enough on their children early in the legal process allowing their children to fall deeper into the system. Placement parents expressed concern that their input is not received when their child is being placed at a particular placement.29

Demographic ProfileGeneral County DemographicsSacramento County is comprised of seven cities: Sacramento, Citrus Heights, Rancho Cordova, Folsom ,Elk Grove, Galt, and Isleton; however, there are 28 communities that are census-designated places:Antelope , Arden-Arcade, Carmichael, Clay, Courtland, Elverta, Fair Oaks, Florin, Foothill Farms, Franklin,Freeport, Fruitridge Pocket, Gold River, Herald, Hood, La Riviera, Lemon Hill, McClellan Park, NorthHighlands, Orangevale, Parkway, Rancho Murieta, Rio Linda, Rosemont, Vineyard, Walnut Grove, andWilton.1Population:Sacramento County’s population estimate as of 2015 is 1,501,335, which is up 32,783 from 2011. Over aquarter of the population, 30.7%, are under the age of 18, which is a slight decrease of 2% from 2010.Children under the age of five make up 6.6% of the population. Conversely, the “over 65” population hasincreased slightly at 2% since 2010. Veterans make up 92,734 of the population, about 6%. SacramentoCounty has 2.2% more females than males, which is a 1% increase from 20107.Sacramento County by Age Sacramento County by Gender 2015 % 2015 % 30 Sacramento 48.9 51.1 Female County by Male 20 Age 2015 % Data source1 10 0 Under 5 Under Over 65 18Data source1Ethnicity estimates since 2015 show a decrease of 2.4% “White, not Hispanic or Latino” populations but California - Child and Family Services Reviewan increase of 6.8% “White” populations since 2010. “Black or African American” populations comprise10.9%, which is a slight .5% increase from 2010. “Hispanic or Latino” populations are at 22.7%, up 1.1%from 2010, and Asian populations are at 16%, up 1.7% from 2010. “American Indian and Alaska Native”populations are slightly up by .6% and make up 1.6% of the population. “Two or More Races” are slightlydown by .5% and consists of 6.1% of the population. Sacramento County in comparison to the State ofCalifornia has a similar number of “White” residents when adding “White” and “White, not Hispanic orLatino” groups together; however, Sacramento has 4.4% more Black/African Americans and 1.3% moreAsians. Conversely, Sacramento has 16.1% less Hispanic/Latino residents than California1.1 http://www.census.gov/quickfacts/table 30

Sacramento County and California by Ethnicity 2015 Ethnicity Sacramento California White 64.3% 72.9% White, not Hispanic or Latino 46% 38% Black or African American 10.9% 6.5% American Indian and Alaska Native 1.6% 1.7% Asian 16% 14.7% Native Hawaiian and Other Pacific Islander 1.2% .5% Hispanic or Latino 22.7% 38.8% Data source1 Two or More Races 6.1% 3.8% According to 2010 through 2014 American Community Survey five year estimates, 20.1% of the Sacramento population are foreign born1, and as of 2014, 20.9% speak another language other than English at home. Out of that group 8.6% rated themselves as speaking English “less than well”. In Sacramento County, Spanish comprises 13% of the population, while Asian and Pacific Islanders are 3.3% and Other Indo-European are 3.7%.2 Sacramento County Languages Spoken At Home 2014 English only 79.1% Language other than English 20.9% Spanish 13% Other Indo-European Languages 3.7% Asian and Pacific Islander Languages 3.3% Other Languages 0.9% Table source3 Median Income: The median household income in Sacramento County as of 2014 was $55,615 while individuals at or below the poverty level were at 18.1%2. Poverty was measured by the Federal Poverty Guideline, which in 2014 was $23,850 for two adults and two children. Currently in 2016, that same guideline has increased by $450.00, now at $24,300.4California - Child and Family Services Review Data available from 2013, showed Sacramento County residents with income below the poverty level ($23,550.00 in 2013) to be at 29.2% when compared to the state of California at 22.1%. Poor families consisting of “females with no husband present” were at 52.8% as compared to “males with no wife present” at 10.4% and “married–couple” families at 36.8%. Notable was Sacramento County had 33.2% of children below the poverty level as compared to California at 23.1%. In Sacramento County, poverty rates among “high school students not in families” were 19%, which was similar to California at 18%. Also similar were poverty rates for “people who did not graduate high school”, at 43.9% for Sacramento and 43% for California.5 Of children ages 0-17 living in poverty in 2013, Black/African American children were highest at 44.9%, followed by Latino children at 34.3%, Asian children at 21.2%, and then White children at 16.2%6. Significant is that at that time, the child population by race was 10.4% Black/African; 2 https://www.census.gov/quickfacts/table/PST045215/06067,00 3 http://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?src=bkmk 4 http://familiesusa.org/product/federal-poverty-guidelines 5 http://www.city-data.com/poverty/poverty-Sacramento-California.html 6 http://cpehn.org/chart/children-poverty-sacramento-county-2011-201331

however, they represented nearly half (44.9%) of children in poverty. Conversely, White children madeup 35.3% of the population and less than half (16.2%) were in poverty. Hispanic/Latino children althoughcomprising 30.7% of the population, had 34.3% in poverty, while Asians at 14% of the population had21.2% in poverty.As of 2015, child populations in Sacramento County have not varied significantly. White childrencomprise 34.8% of the population compared to 35.3% in 2013, Hispanic/Latino are 31% compared to30.7% in 2013, Asians are 14.1% compared to 14% in 2013, and Black/African American are 10.3%compared to 10.4% in 20137. Sacramento County Percentage of Children, ages 0-17, Comparison by Race and Living in Poverty 2011-2013Race Children by Race Children in PovertyBlack or African American 10.4 44.9Hispanic/Latino 30.7 34.3Asian 14 21.2White 35.3 16.2Areas of concentrated poverty within Sacramento County are generally highest in the southern andnorthern areas. Data available from 2013 show highest poverty of 64.3% in the Fruitridge Pocket arealocated southwest of Sacramento County, followed by the north area community of McClellan Park at55.8%, and south area communities, Lemon Hill at 54.5% and Parkway at 42.9%8. The southeast city ofIsleton, located near the Sacramento-San Joaquin River Delta, has a high percentage of poverty (40.3%)8;however, they also have a low population (822 in 2013 and 834 in 2015)9. The next high poverty area isNorth Highlands at 38.4%, a community located next to the second highest poverty area, McClellanPark. North Highlands is followed by Florin, a community in the south that was at 34.7 percent. Lowestpoverty areas were located east in Rancho Murieta, 5%; Folsom, 5.2%; and Gold River, 3.0%. On thefollowing page is a table showing Sacramento County Cities/Communities Percentages of ConcentratedPoverty and Region8. Sacramento County Cities/Communities Percentages of Concentrated Poverty & Region 2013Cities/Communities Percentage Region South-CentralFruitridge Pocket community 64.3 NorthMcClellan Park community 55.8 South California - Child and Family Services Review SouthwestLemon Hill community 54.5 South NorthParkway community 42.9 South North City of Isleton 40.3 East-Central CentralNorth Highlands community 38.4 South East-CentralFlorin community 34.7Foothill Farms community 31.4La Riviera community 31.2City of Sacramento 29.2 City of Galt 28.2Arden-Arcade community 26.17 http://www.kidsdata.org/topic/33/child-population-race/Pie#fmt=144&loc=344&tf=73&ch=7,11,726,10,72,9,73&pdist=738 http://www.city-data.com/poverty/poverty9 http://www.california-demographics.com/isleton-demographics 32

City of Rancho Cordova 26.1 East 24.1 South Rosemont community 23.4 Northeast 22.2 Northwest City of Citrus Heights 20.9 North 20.3 Southwest Walnut Grove community 17.8 North 18.4 Southwest Rio Linda community 16.9 South 15.2 East Vineyard community 15.0 South 14.4 Northwest Antelope community 12.6 Northeast 5.5 East Wilton community 5.2 Northeast 3.0 East Herald community Fair Oaks community City of Elk Grove community Elverta community Orangevale community Rancho Murieta community City of Folsom community Table Source8 Gold River community Housing: In 2015, Sacramento County had approximately 563,656 housing units, which was an increase of 7,724 from 2010. Between the years of 2010 and 2014, an estimated 55.9% were home owners. During those years the median value of an owner-occupied housing unit was $236,500; the monthly owner cost with a mortgage was $1,795; the monthly owner cost without a mortgage was $454; and the gross rent was $1,035. Persons per household was 2.74, and 80.7% were living in the same house one year ago10. In January 2015, the homeless hand count was approximately 2,659 people, which was five percent higher than in 2013. Out of the 2,659 homeless people, more than 1,000 were found to be suffering from substance abuse and/or mental health illnesses, more than 300 were military veterans, 948 were living on the streets, and 1,711 were living in shelters11. Additionally, data available from 2014 shows that 5.4% of public school students were homeless compared to 4.8% in California12.California - Child and Family Services Review Education: According to 2010-2014 American Community Survey five year estimates, the percentage of Sacramento County residents, age 25 and older who have graduated from high school, were 86.2% of the population. Those who had a Bachelor’s degree or higher comprised 28.2% of the population13. High School graduation rates have mostly been gradually improving since 2012 especially for African American/Black, Asian American, and Hispanic/Latino students. Filipino and Asian American students have the highest graduation rates, followed second by White students. Lowest graduation rates were in American Indian/Alaska Native followed second by African American/Black, then Multiracial and Hispanic/Latino students. The table on the following page shows Sacramento County High School Graduates by Ethnicity during the years 2012 through 201414. 10 https://www.census.gov/quickfacts/table/PST045215/06067,00 11 http://www.sacbee.com/news/local/article28671886.html (Story: Number of homeless people in Sacramento County largely unchanged, survey shows) 12 www.kidsdata.org/topic/230/homeless-students/table 13 http://www.census.gov/quickfacts/table/EDU635214/06067 14 http://www.kidsdata.org/topic/755/highschoolgraduatesrace/table#fmt=1154&loc=2,344&tf=79&ch=7,11,726,85,10,72,9,73&sortColumnId=0 &sortType=asc33

Sacramento County High School Graduates by Ethnicity 2012-2014 Ethnicity 2012 2013 2014 70.0 African American/Black 65.0 68.3 66.1 90.9American Indian/Alaska Native 57.9 70.2 93.0 74.6 Asian American 88.2 89.7 80.7 84.1 Filipino 91.3 93.8 77.9 Hispanic/Latino 70.8 72.9Native Hawaiian/Pacific Islander 75.3 79.4 White 81.5 84.1Data Source14 Multiracial 77.0 73.7Unemployment:During the years of 2011 through June 2016, Sacramento County’s unemployment percentage rateshave remained fairly similar to California, differing usually only by a range of 0.1% – 0.6% higher or lowerper month. Since 2013, Sacramento County’s unemployment rate has been for the most part slightlylower than California as a whole; however, in the last two available data months of May 2016 and June2016, Sacramento had higher numbers. In May 2016, Sacramento was at 5.9% as compared to Californiaat 4.7%; however, the following month in June 2016, Sacramento County was only 0.3% higher thanCalifornia (5.7%)15. Significant is that unemployment has dropped in half since 2011 from its highestaverage number of 12% down to 5.5% (in 2016)15, which owes its progress in part to the economyimproving after the 2008-2012 California budget crisis that had a significant impact on job loss forseveral years. The table on the next page shows Sacramento County percentage of unemploymentversus California for the years of 2011 through 201616. Sacramento County % of Unemployment versus California 2011-2016 2016 2016 California - Child and Family Services ReviewMonth 2011 2011 2012 2012 2013 2013 2014 2014 2015 2015 Sac Ca 5.6 5.8 Sac Ca Sac Ca Sac Ca Sac Ca Sac Ca 5.5 5.7 Jan 12.8 12.6 11.2 11.4 10.1 10.3 8.3 8.5 6.8 7.3 5.2 5.6 Feb 12.5 12.3 11.0 11.3 9.4 9.7 8.2 8.5 6.4 6.8 4.9 5.2March 12.3 12.1 11.0 11.1 9.1 9.4 8.1 8.4 6.0 6.5 5.9 4.7 April 11.8 11.5 10.2 10.3 8.4 8.7 7.1 7.4 5.7 6.1 6.0 5.7 May 11.7 11.4 10.2 10.2 8.5 8.6 6.8 7.1 5.8 6.2 – 5.9 June 12.6 12.0 10.8 10.7 9.2 9.2 7.1 7.3 5.8 6.2 – – July 12.8 12.3 11.2 11.0 9.3 9.4 7.7 7.9 6.2 6.5 – –August 12.4 12.0 10.7 10.5 8.9 8.9 7.2 7.5 5.9 6.1 – – Sept 12.0 11.5 10.1 9.7 8.5 8.5 6.9 6.9 5.4 5.5 – – Oct 11.7 11.3 10.0 9.7 8.5 8.5 6.8 7.0 5.7 5.7 – – Nov 11.1 11.0 9.6 9.5 8.0 8.2 6.8 7.1 5.6 5.7 Dec 10.9 11.0 9.5 9.6 7.6 7.9 6.2 6.7 5.6 5.8Data source1715 http://www.homefacts.com/unemployment/California/Sacramento-County.html16 https://en.wikipedia.org/wiki/2008%E2%80%9312_California_budget_crisis17 http://www.homefacts.com/unemployment/California/Sacramento-County.html 34

Federally Recognized Tribes: Sacramento County has two federally recognized tribe, the Buena Vista Rancheria of Me-Wuk Indians and Tribe of Miwok people, Wilton Rancheria.18 Sacramento County utilizes the Sacramento Native American Health Center (SNAHC), which provides an array of services to families with Native American children, including but not limited to mental health, outpatient substance abuse, domestic violence, and anger management services; home visitation program for families; and medical, dental, vision services. Between the years of 2012 through 2015, an average of 210.25 “referrals” were received per year for Native American children; an average of 56.5 contained “substantiated referrals” per year; an average of “first entries” per year comprised 19.5 children; average “subsequent entries” per year were 8.25 children; and average “in care” per year consisted of 50.5 children being served. The table below shows the actual numbers per year of Native American children in relation to referrals received, substantiated referrals, first entries into care, second entries, and children in care. Sacramento County Native American Children Referrals Received CY 2012 CY 2013 CY 2014 CY 2015 Average Per Year Substantiated Referrals 2012-2015 First Entries 212 213 203 213 Subsequent Entries 51 56 52 67 210.25 Children in Care 19 17 17 25 56.5 7 13 7 6 19.5 Data Source19 49 47 52 54 8.25 50.5 Child Maltreatment Indicators Number and Proportion of Newborns with Low-Birth Weight In 2013, 1,298 infants were born in Sacramento County with low-birth weight which accounted for 6.7% of all births, compared to the statewide rate of 6.8%. Between 2003 and 2013, Sacramento County experienced higher percentage in 2005, 2006 and 2010 at 7.1%.20California - Child and Family Services Review 18 http://www.cbgusa.com/ca/sacramento/federally-recognized-indian-tribes/ 19 http://cssr.berkeley.edu/ucb_childwelfare/ 20 http://www.kidsdata.org/topic/301/lowbirthweight/trend#fmt=91&loc=2,344&tf=13,7335

African American/Black mothers have the highest rate of infants born at low birthrate compared toother race/ethnicity. Though the trend is decreasing, in 2013 African American/Black mothers had a9.5% rate while White mothers were at 5.5%. Asian/Pacific Islander had the second highest rate at7.7%.21Number and Proportion of Children Born to Teen Parents California - Child and Family Services ReviewSince 2008, there has been a decrease in rate of births for teenage mothers between the ages 15-19 inSacramento County. In 2008, the rate was 38.0 births per 1,000 females; in 2013 the rate dropped to22.3 births per 1,000 females, while California’s rate as at 23.2 per 1,000 females.2221 http://www.kidsdata.org/topic/302/lowbirthweight-race/table#fmt=92&loc=344&tf=73,67,64,46,37,16,10,9,8,7&ch=7,8,507,9&sortColumnId=0&sortType=asc22 http://www.kidsdata.org/topic/314/teenbirths/trend#fmt=1192&loc=344,2&tf=13,73 36

Family Structure (Number and Proportion of Single Parent Homes, Grandparent Homes) According to the 5-year estimates from the American Community Survey, Sacramento County has 519,460 households with 65.6% are families and 31.8% of households living with own children. The average family size is 3.46 individuals. California has 12,617,280 households with 68.7% are families and 32.4% of households living with own children. The average family size for California is 3.54 individuals. Sacramento has a lower percentage of married-couple family households at 67.9% compared to California at 71.5%. At the same time Sacramento is slightly higher with female householder families.23 Family Household Source: ACS 2010-2014California - Child and Family Services Review Total family households CA: 8,666,826; Sacramento: 340,777 23 http://factfinder.census.gov/faces/nav/jsf/pages/searchresults.xhtml?refresh=t#none37

When looking at households living with their own children under the age of 18 years old, Sacramento California - Child and Family Services ReviewCounty trends the same way. Sacramento has lower percentage of married-couples at 64.2% comparedto California at 69.6 %. Sacramento is experiencing a greater percentage of households headed byfemales with 26.3% while California is at 22.0%.23 Family Households Living with Own Children Under 18 years Source: ACS 2010-2014 Total family households living with own children under 18 years CA: 4,083,121; Sacramento: 165,053Sacramento County has approximately 38,511 living with their own grandchildren. Of thosegrandparents, 29.7% are responsible for their grandchildren. California has a rate of 26.4% responsiblefor their grandchildren.23 38

California - Child and Family Services ReviewGrandparents living with own Grandchildren under 18 Source: ACS 2010-2014 In Sacramento County, White grandparents had the largest rate of caring for their grandchildren at 46.8%. The second largest group was Asian/Pacific Islanders with a rate of 27.7%, while California had a rate of 10.7%. For African American/Black grandparents 11.5% of them are for caring for own grandchildren.23 Grandparents responsible for own Grandchildren under 18 Source: ACS 2010-2014 Total grandparents living with own grandchildren under 18 CA: 1,131,311; Sacramento: 38,511 Total grandparents responsible for own grandchildren under 18 CA: 298,964; Sacramento: 11,45439

Housing Cost and Availability California - Child and Family Services ReviewAccording to the April 1, 2015 Comprehensive Housing Market Analysis for Sacramento County, thesales vacancy rate has declined to a current estimated rate of 1.8 percent, down from 2.5 percent inApril 2010.24 Existing home sales declined 9 percent to 17,800 homes during the 12 months endingMarch 2015, while average sales price of an existing home increased 10 percent to $281,700. As ofMarch 2015, 2.3 percent of home loans were seriously delinquent or had transition into real estateowned status. This is down from 2.9 percent in March 204 and down from 7.0 percent in March 2008.The number of new homes sold during the 12 months ending March 2015, approximately 1,250 newhomes were sold, a 100-home, or 8 percent, decline compared with the previous 12 months. Thedecline in new home sales is because of an 11 percent increase in the average sales prices of a newhome, to $387,000. From 2012 through 2014, the average sales price of new home has increase anaverage of 11 percent, annually.During the next 3 years, demand is estimated for 8,875 new homes. The 620 homes currently underconstruction and some of the estimated 14,700 other vacant units that might reenter the market willsatisfy part of the forecast demand. Prices for new homes currently start at $150,000. Homes at thelower end of the price spectrum generally represent condominium units.The overall rental vacancy rental rate in Sacramento County is 5.8 percent, down from 8.4 percent as ofApril 2010. Single family homes for rent represent 45 percent of the overall rental inventory. During thefirst quarter 2015, the apartment was 2.8 percent vacancy rate, down from 3.9 percent during the firstquarter 2014 and down from 5.1 percent during the first quarter 2010. The apartment vacancy rateduring the first quarter 2015 was lowest in Citrus Heights area at 1.5 percent and highest in CentralSacramento area at 3.7 percent. The average rent was $971 during the first quarter of 2015, a 6-percentincrease from $920 during the first quarter of 2014 and a 14-percent increase from $850 during the firstquarter of 2010. During the first quarter 2015 rents ranged from $920 in Rancho Cordova/EastSacramento to $1,325 in the Central Sacramento. Average rent increase ranged from 2 percent in theSouth Sacramento area to 8 percent in the Arden-Arcade, Carmichael and Citrus Heights market areas.Central Sacramento area is mostly affected by CSU Sacramento student renters and has the highestrents in the area. From the first quarter of 2010 to the first quarter of 2015, the apartment vacancy ratein the market area declined from 7.0 percent to 3.7 percent, while the monthly rent increased anaverage annual rate of 3 percent, during the same period.Multifamily constructions, a measure by the number of units permitted averaged 480 units from 2009through 2014. Condominium units accounted for only 4 percent of all multifamily units permitted.During the 12 months ending March 2015, 250 units were permitted, nearly double the 130 unitspermitted during the previous month period. During the next 3 years, demand is estimated for 4,375rental units. The 450 units currently under construction will satisfy some of that demand.2-1-1 Calls: monthly averages by assistance requestIn calendar year 2015, Sacramento County 2-1-1 call line received 108,809 calls. This was a 6.4%decrease compared to 2014. When looking at client profile, 73.4% were females; 24.4% were males and2.2% gender identity was unknown. The top five zip codes were 95823, 95815, 95821, 95825, and95838. The majority of services requested were housing with 45.6%. Housing services includedEmergency Shelter/Transitional housing, Low Income/Subsided Housing, Housing Search Assistance,24 https://www.huduser.gov/portal/ushmc/regional_state.html?stateid=6 40

Rent Payment/Rent Deposit Assistance and Landlord/Tenant Assistance. The second most common request was Legal, Consumer and Public Safety. 25 2-1-1 Calls for Assistance By Top Needs Expressed in Sacramento County Source: 2-1-1 Annual Statistical Report January - December 2015 Housing 45.6% Legal, Consumer, and Public Safety 15.7% Family And Community Support 10.7% Income Support and Assistance 10.5% Information Services 10.1% Food/Meals 8.6% Utility Assistance 8.4% Health Care 7.8% Mental Health & Addictions 5.9% Clothing/Personal/Household 4.7%California - Child and Family Services Review Other Government/Econonomic Services 2.4% 0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0% 35.0% 40.0% 45.0% 50.0% Substance Abuse Data Current data on the prevalence of substance abuse in Sacramento County is difficult to gather. In 2016, Sacramento County Alcohol and Drug Services spearheaded two taskforce to address the Opioid and Methamphetamine problem in the County. A more detail report on the prevalence of substance abuse is being developed by Sacramento County Alcohol and Drug Services and expected to be released in 2017. 25 http://www.211sacramento.org/211/about-us/2-1-1-statistics/41

Using records from the California Outcome Measurement System (CalOMS), of all individuals admittedto alcohol and drug treatment services in Sacramento County in Fiscal Year 2014-2015, opiates were thehighest primary drug of choice reported at 45 percent. The second highest was methamphetamine at25 percent. Alcohol and Drug Services Treatment Data Fiscal Year 2014-15 Source: California Outcome Measurement System (CalOMS) Drug of Choice Number of Clients Using Percentage of Clients Overall Specified Drug Per Specified Drug Opiates 2,817 45% Methamphetamine 1,573 25% Marijuana 1,175 19% Alcohol 700 11%Total Number of Clients 6,265 100%When looking at primary drug of choice by zip codes, there was a group with no zip code identified. It isassumed that those are homeless clients. Homeless/no zip codes population ranked highest use forOpioid as their primary drug of choice at 18.6%, followed by Land Park/Pocket/Meadowview communityof 12.6% and then Rancho Cordova with 8.7%. Methamphetamine as the primary drug of choice washighest in the homeless/no zip code population with 34.1%, followed by South Sacramento at 10.8% andNorth Sacramento at 7.7%. Marijuana as a primary drug of choice was highest in South Sacramento with17.2%, followed by Rancho Cordova with 14.5% and then homeless/no zip code population at 10.3%.Alcohol as the primary drug of choice was 10.3% for homeless population, 7.2% for Rancho Cordova and6.7% for South Sacramento. Primary Drug of Choice by Community Boundaries Fiscal Year 2014-15 Source: California Outcome Measurement System (CalOMS) Community Boundaries Methamphetamine Opioid Alcohol Marijuana 1.7%Antelope 1.3% 1.9% 0.5% 6.2% 1.8%Arden Arcade 5.2% 6.5% 5.5% 3.4% 2.2%Carmichael 1.7% 4.4% 4.7% 0.9% 5.7%Citrus Heights 3.9% 5.8% 3.8% 4.9% California - Child and Family Services Review 0.7%Delta 0.4% 0.7% 0.9% 1.4% 1.7%Downtown 2.5% 3.8% 4.1% 10.3% 6.1%East City 4.2% 3.6% 5.3% 5.4% 0.9%Elk Grove/Franklin/Laguna 1.9% 2.9% 5.0% 7.3%Fair Oaks 0.4% 2.1% 2.1%Folsom Area 1.0% 1.4% 1.9%Galt 0.8% 0.1% 1.4%Homeless/no zip code 34.1% 18.6% 27.6%Land Park/Pocket/Meadowview 3.9% 12.6% 5.0%North Highlands/Foothill Farms 7.2% 5.5% 4.8%North Natomas 0.1% 0.6% 1.2%North Sacramento 7.7% 4.8% 5.5% 42

Orangevale 1.0% 2.0% 1.7% 0.5% Rancho Cordova 5.2% 8.7% 7.2% 14.5% Rancho Murrieta 0.0% 0.0% 0.2% 0.0% Rio Linda/Elverta 2.2% 1.9% 1.0% 1.0% South Natomas 3.7% 3.7% 2.9% 5.1% South Sacramento 10.8% 7.8% 6.7% 17.2% Southeast 0.2% 0.1% 0.0% 0.1% Vineyard 0.6% 0.5% 0.9% 1.0% 100.0% 100.0% 100.0% 100.0% According to the 2010 report on Indicators of Alcohol and Other Drug Risk and Consequences for California Counties, the rate of hospitalizations due to alcohol and drug use decreased from 176 per 100,000 in 2000 to 169 per 100,000 in 2007. Sacramento County’s drug and alcohol related hospitalization rate was also much lower than California overall each year. 26 Hospitalizations Due to Alcohol and Drug Use Rate per 100,000 240 220 200 2001 2002 2003 2004 2005 2006 2007 180 160 140 120 2000 California SacramentoCalifornia - Child and Family Services Review In the same 2010 report, crime rates for felony and misdemeanor drug offenses decreased from 1,028 per 100,000 in 2000 to 823 per 100,000 in 2008. Sacramento County’s drug arrest rate was lower than California starting in 2001. Drug arrest rates were highest among Blacks at 3,400 per 100,000 in 2008, significantly higher than each other race/ethnicity group each year. The highest rate of arrests for drug‐related crime was for 18 to 24 year olds with a rate of 1,468 per 100,000 in 2008. The next highest rate was for 25 to 34 year olds with a rate of 1,311 per 100,000. 35 to 44 year olds also had a high drug arrest rate at 1,038 per 100,000 in 2008.27 26 http://www.ca-cpi.org/docs/County_Data_Files/Sacramento_10.pdf 27 https://dch.georgia.gov/sites/dch.georgia.gov/files/related_files/document/2013_Federal_Poverty_Guidelines_DCH.pdf43

population 10 to 69 Years Arrests for Drug-Related CrimeRate per 100,000 1100 1050 1000 950 900 850 800 2000 2001 2002 2003 2004 2005 2006 2007 2008 California SacramentoThe Arrestee Drug Abuse Monitoring (ADAM) Program II 2013 Annual Report has data from 2007-2013. California - Child and Family Services ReviewThe information is compared to an earlier ADAM project with data from 2000-2003. Sacramento had 83percent arrestees testing positive for some drug in their system at the time of arrest and booking. Theproportion of arrestees testing positive for drugs at the time of arrest has increased since 2000-2003 by8 percent. In 2013, many arrestees also tested positive for more than one drug in their system at thetime of arrest. In Sacramento 50 percent of arrested had more than one substance in their system atarrest. This is an increase by a third from 2000-2003.Marijuana was the drug most commonly detected in adult male arrestees. In 2013, 59 percent testedpositive for Marijuana. The second most common was methamphetamine at 51 percent. Sacramentosaw also a jump in positive test for opiates from 3 percent in 2000 to 18 percent in 2013.2828 https://www.whitehouse.gov/sites/default/files/ondcp/policy-and-research/adam_ii_2013_annual_report.pdf 44

Percent of Arrestees Testing Postive Urine Test Results Among Adult Male Arrestees Marijuana Methamphetamine 70 Cocaine 60 Opiates 50 40 30 20 10 0 2000 2001 2002 2003 2007 2008 2009 2010 2011 2012 2013California - Child and Family Services Review Mental Health Data In the Sacramento County Mental Health Plan CAEQRO Report FY 2011-2012, 16,209 people were served with 8,258 being 0-17 year olds for CY 2010. In Sacramento County, the percentage of people who receive services compared to those who are eligible for services was 5.08%, which was slightly lower than California’s rate of 5.65%. For the Foster Care population, the percentage of children who receive services compared to those who are eligible for services was 56.69%. This was lower compared to California rate, 61.29%. Whites are the highest beneficiaries at 41.1%. African-American were the second highest beneficiaries with 25.99% and Hispanic were third at 17.06%.29 In 2012 there was an estimated 74,268 people needing mental health services in Sacramento County of which 27,216 were for 0-17 year olds.30 In the Sacramento County Mental Health Plan CALEQRO Report FY 2015-2016, 20,257 people were served in CY 2014. Sacramento County’s penetration rate of 5.00% was lower than California’s rate with 5.19%. Sacramento County’s Foster Care penetration rate was slightly lower than California, but both were around 45%. In general there has been a small downward trend in foster care rate for Sacramento and California. Whites continue to be the highest beneficiaries at 35.57%. Second highest was African- American at 22.88% then Other at 16.72% and Hispanics at 16.39%.29 During FY 2015/2016, 31,271 unduplicated adults and children were served through the mental health system of care31. There were 19,775 adults and 11,496 children served during the fiscal year. Of those served, 1,277 was also part of the foster care system of care. South Sacramento had the highest number of clients served in all three groups: 17.2% for adults; 21.5% for children; and 17.8% for Foster Care. The next two highest communities for adult clients were North Sacramento 9.8% and North Highlands/Foothills Farm 8.7%. For children, North Highlands/Foothill Farms was the second highest with 10.2%, followed by North Sacramento with 8.4%. Foster Care clients had high rates in Rancho Cordova 10.9%, Elk Grove 10.4% and Arden Arcade 10.3%. 29 http://www.dhhs.saccounty.net/BHS/Documents/Reports--Workplans/2011-12-CAEQRO-Report.pdf 30 http://www.dhcs.ca.gov/provgovpart/Documents/CaliforniaPrevalenceEstimates.pd 31 Sacramento County Behavioral Health Services Avatar database and CWS/CMS45

Percentage of Mental Health Services by Sacramento County Community Boundaries FY 2015/2016 Cities/Community Boundaries Adults Children Foster CareAntelope 1.6% 2.7% 1.5%Arden Arcade 8.3% 6.4% 10.3%Carmichael 4.1% 3.6% 3.4%Citrus Heights 4.1% 5.7% 4.4%Delta 1.2% 1.7% 1.9%Downtown 7.7% 1.1% 1.2%East City 7.0% 5.8% 5.0%Elk Grove/Franklin/Laguna 4.3% 6.6% 10.4%Fair Oaks 1.5% 1.3% 0.6%Folsom Area 0.9% 0.9% 0.7%Galt 1.4% 1.6% 0.7%Land Park/Pocket/Meadowview 6.2% 6.0% 5.2%North Highlands/Foothill Farms 8.7% 10.2% 8.4%North Natomas 0.9% 1.3% 2.0%North Sacramento 9.8% 8.4% 7.2%Orangevale 1.0% 1.4% 1.2%Rancho Cordova 8.5% 7.8% 10.9%Rancho Murrieta 0.1% 0.1% 0.3%Rio Linda/Elverta 0.3% 0.3% 0.3%South Natomas 4.1% 4.5% 4.8%South Sacramento 17.2% 21.5% 17.8%Southeast 0.2% 0.2% 0.2%Vineyard 0.9% 1.1% 1.9% 100.0% 100.0% 100.0%Source32Child Fatalities and Near Fatalities California - Child and Family Services ReviewThe Child Abuse Prevention Center published the Child Death Review Team 2010 – 2012 Three YearReport.33 According to the report, 413 children, birth through 17 years of age, who were residents of orwhose injuries occurred in Sacramento County, died during the period 2010-2012. Deaths by naturalcauses were 79% (325 of 413); injury related deaths were 19% (80 of 413) and undetermined deathswere 2% (8 of 413). Between 2000-2012, the three communities with highest rate of deaths occurred inSouth Sacramento at 17.1%, followed by Elk Grove 8.6% and Rancho Cordova 8.1%.The average child death rate decreased from 44.58 (2007-2009) to 37.79 per 100,000 children (2010-2012). The child abuse and neglect homicide rate also decreased from 1.82 deaths (2007-2009) to 1.02deaths per 100,000 (2010-2012). During this report period, 11 of the injury related deaths (14%) werethe result of a child abuse and neglect homicide. Half of the injury related deaths (40 of 80) were youth10 to 17 years of age. Of these, 19 deaths were third party homicides, two were child abuse and neglecthomicides and 10 were suicides.32 Sacramento County Behavioral Health Services33 http://www.thecapcenter.org/why/research-and-publications/child-death-review-team 46

Other major findings include:  Nearly one-fifth of child deaths were injury-related and preventable.  The majority of perpetrators of child abuse and neglect homicides in Sacramento County are biological parents.  Nearly half of child abuse and neglect homicide perpetrators have a known history of involvement with Child Protective Services as children.  Three-fourths of child maltreatment deaths occurred in children five years of age or under.  African-American children died at a rate more than two times higher than that of all children in Sacramento County.  The number of infant sleep-related deaths has decreased.  There is a statistically significant correlation between infant sleep-related deaths and Child Protective Service referrals.  Families of decedents are more likely to be enrolled in government aid programs.  Since 2007 the number of youth deaths due to motor vehicle collisions decreased by 85%  The number of injury-related youth deaths decreased by half.  Half of youth suicide decedents had a family history of mental health issues. Number & Percentage of Child Death by Sacramento County Community Boundaries 200-2012 Cities/Community Boundaries Deaths Percentage South Sacramento 353 17.3% Elk Grove/Franklin/Laguna 177 8.7% Rancho Cordova 167 8.2% North Highlands/Foothill Farms 160 7.9% North Sacramento 155 7.6% East City 155 7.6% Land Park/Pocket/Meadowview 152 7.4% Arden Arcade 127 6.2% Citrus Heights 97 4.7% South Natomas 92 4.5% Folsom Area 65 3.2% Carmichael 54 2.6% Antelope 51 2.5% Rio Linda/Elverta 42 2.1%California - Child and Family Services Review Vineyard 34 1.7% Delta 11 0.5% Fair Oaks 31 1.5% Galt 29 1.4% North Natomas 28 1.4% Downtown 24 1.2% Orangevale 25 1.2% Southeast 11 0.5% Rancho Murrieta 6 0.3%47

Children with Disabilities (as applicable)In 2015, Sacramento County had an estimated 3.6% children under the age of 18 with one or moremajor disabilities, which was slightly more than California at 3.1%. Over the past five years Sacramentohas fluctuated with the highest at 4.6% in 2011 and 2014.34 Children with Major Disabilities 2011-2015 (Regions of 65,000 Residents or More)5.0%Percent of Children under age 18 California - Child and Family Services Review4.5%4.0%3.5%3.0%2.5% 2012 2013 2014 2015 2011 California SacramentoBetween 2011 and 2015, Sacramento County and California have seen an increase in special educationenrollment. Sacramento County special education enrollment is above California’s rate. In 2015Sacramento County had 12.4% and California had 11.5%. (Sacramento County’s special educationenrollment by disability: the top three were Learning Disability at 41.2%, Speech or LanguageImpairment at 22.6% and Autism at 11.4%.34)34 http://www.kidsdata.org/topic/92/special-needs-majordisabilities/table#fmt=242&loc=344,2&tf=64,67,73,79,84&sortType=asc 48

Special Education Enrollment: 2011-2015 Percent of Public school Children 13.0% grades K-12 12.5% 12.0% 11.5% 11.0% 10.5% 10.0% 9.5% 9.0% 2011 2012 2013 2014 2015 California Sacramento Rates of law enforcement calls for domestic violence (as applicable) The rate of domestic violence calls to Law Enforcement in Sacramento County in 2014 was 5.8 calls per 1000 adults ages 10-69. This rate was slightly lower than the state-wide rate of 6.0 calls per 1000 adults ages 18-69. The graph below shows that the rate in Sacramento County has decreased significantly from 2010.34 Domestic Violence Calls for Assistance: 2010-2014California - Child and Family Services Review 8.5 2011 2012 2013 2014 Domestic call rate (per 8 1,000 adults ages 18-69) 7.5 7 6.5 6 5.5 5 2010 California Sacramento The chart below lists the number of domestic violence calls broken down by weapon use and the type of weapon involved. In the past five years, the use of personal weapon increased by 542 calls. In 2010 personal weapon totaled 1,529 (20.52%) while in 2014 it totaled 2,071 (36.53%). At the same time the rate of domestic violence calls has declined since 2010.35 35 https://oag.ca.gov/crime/cjsc/stats/domestic-violence49