summary: Facility Evaluation

raw_content:
Narrative:
On March 1, 2022, at 9: AM Licensing Program Analysts (LPA's) Enrique Hernandez and Nancy O'Connell conducted an unannounced inspection, at the above-said facility, for the purpose of conducting an Annual /Required Inspection. Licensing staff was met by Mydori Saipale Facility Administrator (FA) and Tone Reyes the Director who granted access into the facility, who provided a tour of the entire facility, inside and out. This is a one-story home 3 bedroom, 8 bathroom, 3 therapy room, a living room, dining room, kitchen, breakfast area, family room, garage, laundry area, and a backyard. There are no facility cameras on the premises. There are no security bars on the windows. There are no firearms or dangerous weapons in the home. Medicines are inaccessible to children. All smoke detectors were tested and are operating properly in the home at the time of visit. There are numerous fully charged fire extinguishers available. Outdoor activity space free of obstructions. During the inspection LPA measured the water temperature and measured within safe temperature at 119 degrees Fahrenheit. First aid kits were checked and complete with scissors, tweezers, thermometer, gauzes, antiseptic and 1st Aid Manual. All posting requirements for the Licensee's Foster Care License and Emergency Plan will be met, aside from the Group Home License. There are covered fireplaces in the house and the Director stated that they are not working. Currently the facility has two insured Toyota Siennas capacity to transport 6 clients and is equipped with a fully charged fire extinguisher. Seat belts were observed to be in good repair at the time of the inspection. Continue On LIC 809-C LPAs observed the following during inspection: Living Room: with a securely covered fireplace with plenty of seating that has access to the backyard. Dining Room: equipped with a large table with 8 chairs. Kitchen: equipped with a refrigerator, Built-In BBQ, Cooktop - Gas, Double Oven, Microwave, Breakfast Nook, Formal Dining Room, Kitchen Island a sink is located in the island, and plenty of cabinet space. Knives / Sharp objects are stored in a locked drawer space within one of the lower kitchen cabinets. Chemicals and cleaning solutions are kept in locked. Breakfast area: consists of a table with 8 chairs, Family Room: equipped with a secure cover on the fireplace, and plenty of clean furniture in good repair. Garage: locked, finished, 4 garage spaces, equipped with a basketball hoop, pool tale, and plenty of locked cabinets for storage. Facility administrator stated that they are using it as storage and clients are not allowed in there. Laundry area: equipped with a washer and dryer, and plenty of cabinet space cleaning supplies were locked and a fully charged fire extinguisher. School: equipped with a fully charged fire extinguisher, smoke alarm, 6 desk, 10 chairs, a printer, it was stated by the facility administrator that each client shall have access to his/her own laptop during school hours. 3 bedrooms observed to each have its own bathroom, with sufficient lighting, drawer and closet space, comfortable two twin mattresses, and clean lines, blankets, and pillows. Nursing station, Located in the master bedroom equipped with, 3 desk in a table There is a bathroom with two sinks and walking closet first aid kit, and first aid supplies were observed. There is also a small refrigerator for storage of client medication that requires refrigeration. Group Therapy Rooms observed: · Office Therapy Room: equipped with clean furniture in good repair. · Second Therapy Room: equipped with furniture in good repair. The Exterior consists of the following: Pool: Located in the backyard, there is a fencing on the premises that meets regulations. Also, a net was covering the pool, Continue on LIC809-C Due to time constraints, LPA shall return to complete the Annual/Required Inspection by conducting the file review for Six clients (C1, C2, C3, C4,C5 and C6). A copy of this report was discussed with the facility administrator and will be email to the facility due to technical difficulties with the LPA's printer

met_with: Facility Administrator


state: CA

facility_name: NEWPORT ACADEMY-AVOCADO

summary: Facility Evaluation

raw_content:
Narrative:
On March 13, 2024, Licensing Program Analyst Connie Jones-Steward conducted an annual random inspection of the facility. The inspection began at 9: AM. Compliance Specialist Regan Mew and Residential Supervisor Andrew Westfall assisted with the inspection . The following was observed. This is a one-story home with 3 bedrooms, 7 bathrooms, 3 therapy rooms, a living room, dining room, kitchen, breakfast area, family room, garage, laundry area, and a backyard. Although the floor plan shows 8 bathrooms, one was converted to a pantry. Per Ms. Mew, the conversion was done prior to licensure. There are currently 6 female clients who are placed by their parents. There are no security bars on windows. The pool and jacuzzi are enclosed behind a mesh gate that is key locked. There is also a pool cover. There are smoke detectors and carbon monoxide detectors in the hallway between bedrooms. LPA observed several fully charged fire extinguishers. There are 2 fireplaces which are securely gated. Kitchen and bathroom areas are well maintained. Food supply meets Title 22 requirements. Hot water temperature is within a safe range. All medications, knives and household cleaners are safely stored in locked areas. There is a complete supply of first aid items. All bedrooms have two twin bed beds with the required linens in good condition. Each room has the required drawer and closet space. The facility van was checked for working safety equipment. There is a first aid kit and maintenance log kept in the van. The log is filled in after every trip. The facility was cited under Title 22 80087(e)(1) for Buildings and Grounds. LPA reviewed client records including medication logs. A follow-up inspection will be conducted to inspect staff records and to interview staff and clients,

report_type: Facility Evaluation

visit_type: Annual

met_with: Regan Mew, Compliance Specialist


facility_name: NEWPORT ACADEMY-FRENCH CREEK

summary: Complaint Investigation - Substantiated - 1 allegation

raw_content:
Narrative:
During interviews with the Residential Supervisor, Residential Manager, and therapist in the facility, it was reported that C1 had a history of making false statements against and targeting peers prior to being placed at this facility. Staff stated C1 was a resident at another facility for this agency and was moved to this location in hopes to allow C1 to make a new start in a fresh environment. Knowing C1's history, C1 was placed on heightened supervision since their arrival to this facility but not on a one-to-one supervision. Staff admitted that the supervision for C1 was not elevated to one to one as the previous false statements against peers was not of a sexual nature prior to their placement. Staff were aware that C1 needed to be closely monitored. During the approximately one week where C1 and C2 were roommates, the facility did only have one staff supervising youth during the overnight hours and the overnight staff had other duties to be completed during their shift that would take them away from the area where the clients' rooms were located. This left the client rooms unsupervised for periods of 10 to 15 minutes. Confidential interviews with overnight staff indicated that once they became aware of the allegation, they ensured that the area where client rooms were located was never left unsupervised, even for restroom breaks or other rest periods. Overnight staff interview indicated that both youth were sounds sleepers and that there was never a time that youth were awake or woke up while they worked the overnight shift, including the night(s) the alleged allegation occurred. Confidential interviews with youth were not consistent on whether there was any sexual contact between them. As a result of the information obtained and reviewed and interview conducted, the allegation that a lack of supervision resulted in an inappropriate interaction between youth is UNSUBSTANTIATED at this time meaning the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. Exit interview was conducted and documents, including appeal rights, were provided to Mr. Parraz.

Investigation Findings:
13Licensing Program Analyst (LPA) Tamara Hill conducted an unannounced complaint inspection on 5/29/25 at 1: PM and met with David Parraz, Residential Supervisor to discuss the findings of the allegation stated. LPA Hill informed Mr. Parraz that the complaint inspection included an initial inspection at the facility on 4/10/24 and a subsequent inspection on 4/23/25 where information was obtained about clients in care and other incident(s) and interviews were conducted with C1, C2, and staff at the facility. Additional interview with the overnight awake staff was conducted on 5/29/25. LPA Hill informed the agency that the allegation that a lack of supervision resulted in an inappropriate interaction between youth in care is a result of an incident reported by the agency alleging that C1 was sexually assaulted during the overnight hours and on more than one occasion by C2 while they were roommates, within days of the youth being admitted to the facility. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Jodean Hall LICENSING EVALUATOR NAME: Tamara Jensen-Hill LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 23-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SACRAMENTO CRP RO, GOETHE ROAD, SUITE FACILITY NAME: NEWPORT ACADEMY-FRENCH CREEKFACILITY NUMBER: VISIT DATE: 05/29/2025

Allegations:
- SubstantiatedEstimated Days of Completion: Estimated Days of Completion: Estimated Days of Completion:

report_type: Complaint Investigation

met_with: David Parraz, Residential Supervisor

complaint_status: SUBSTANTIATED


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Tamara Hill made an announced Prelicensing inspection on 12/21/21 at 12: PM and met with Pamela Alba, Regional Executive Director and Cassidy Salmina, Residential Supervisor to conduct the prelicensing inspection. LPA observed that the required posting are present in the home and includes personal rights, complaint poster, Ombudsperson poster, grievance policy, COVID-required precautions and grievance procedures.. LPA observed that the home is equipped with three dual occupancy client rooms, five restrooms with five showers, three therapy rooms, one locked medication room, one staff office, and one kitchen that is stocked with cooking supplies and place settings for all six clients and staff. LPA observed that there are six fire extinguishers located throughout the home - LPA did advise the facility to contact the local fire inspector to have the extinguisher inspected and tagged as needed. LPA toured the outside of the facility and observed that there are no health and safety concerns for the outdoors. LPA observed that the outdoor space is appropriate for the clientele to be served. LPA observed that the chemicals are to be stored in a locked closet near the kitchen area. Sharps are to be located under the kitchen sink in a locked cabinet. Medications are stored in a locked medication room and the facility plans to have a locked medication cart where the medications will be stored inside the locked medication room. LPA observed that there is hot water where all clients have access in the bathrooms. LPA observed that the bathroom toilets were functioning as required. All bathrooms were stocked with paper towels as required. LPA reminded the facility that the use of common towels is not allowed in bathrooms that are shared by more than one client. LPA observed that there is a classroom on the premises as well as a gym for client use. LPA observed that the laundry rooms is available to clients and laundry supplies are to be locked and inaccessible to clients. LPA observed that the facility is still trying to get the phone line hooked up as there was an issue with the installation on 12/20/21. LPA observed that the facility has four cell phones available for staff and these phones are available for youth to use until the land line is installed and working. LPA observed that the facility is ready for licensure as soon as the phone is hooked up and working. LPA is recommending that the facility be issued their license upon review of management. Exit interview was conducted with Ms. Alba and Salmina and document provided via email.

visit_type: Prelicensing

met_with: Pamela Alba, Regional Executive Director & Cassidy Salmina, Residential Supervisor


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Tamara Hill made an unannounced post licensing inspection on 3/16/22 at 12: PM and met with Michelle Good, Residential Director. LPA toured the facility inside and out and observed that the agency is in the process of paving the driveway to a lower level parking lot that will be utilized for staff person parking. LPA also discussed the lower house and outbuilding with the facility and was informed that the proposal was put forth today to convert the lower house to a gym for client use. LPA informed the facility that prior to it being utilized by clients, LPA needs to inspect the building and it needs to have a fire clearance approved by the Department. LPA informed the facility that plans for the construction, new facility sketch showing these buildings and their purpose(s), along with building permit(s) need to be submitted to Licensing prior to commencement of work. LPA observed that the smoke detectors and carbon monoxide detector are working as required. LPA observed that the facility had sufficient food in the facility for the amount of clients in care. LPA observed that client rooms are clean and safe for clients and have the proper furnishing for clients. LPA observed that there is adequate food for the clients in care. LPA reviewed client files while at the facility and due to the time restriction was not able to review staff files. LPA did inform the facility that LPA will return to continue the visit on another day. LPA did provide technical advisories for ambulatory status, tuberculosis tests, and room sharing compatibility for clients who share rooms. Exit interview was conducted.

met_with: Michelle Good, Residential Director


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Tamara Hill made an announced post licensing inspection on 3/17/22 at 1: PM and met with Michelle Good, Residential Director. While LPA was conducting a prelicensing at the agency's other house, LPA and Ms. Good conducted a teams meeting with Human Resources via MS Teams to go through staff records. LPA observed some major issues with the personnel records. LPA informed Ms. Good that the documentation related to those issues will be issued on another date as LPA needs to go through the required documentation and citations. LPA informed Ms. Good that the Post Licensing inspection shall continue on another date. At that time, LPA will conduct interviews with staff and clients. Exit interview conducted and only this document was provided to Ms. Good on this date.

visit_type: Case Management


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Tamara Hill continued an unannounced post licensing inspection on 4/5/22 at 3: PM and met with Michelle Good, Residential Director. The inspection on this date was to complete the Post Licensing inspection, that was initiated on 3/16/22, continued 3/17/22 where LPA reviewed personnel records via Microsoft Teams and concluding on 4/5/22. LPA informed Ms. Good that the 3/17/22 inspection was conducted via Microsoft Teams due to the agency not having a personnel person available in this region yet. LPA identified some issues with personnel records and the facility is being provided with the following: The agency stores all of their staff files electronically only but there is no personnel working out of this region that has access to the records to ensure that the appropriate documentation is obtained and stored according to the regulations. The staff that provided access to the records reviewed is from another region of the state and states that she is attempting to complete the appropriate records as the personnel working in their human resources for this region recently quit the agency. LPA observed that the following items are missing from staff files: Proof of training - there were no records found in staff files about any training as required - initial 8 hour and 16 hour training 84065(i) and applicable documented assessment(s) including job shadowing (84065(i)(1)(C)(4), First Aid 80075(f), Cardiopulmonary Resuscitation (CPR) 84065(i)(6), medications training, facility manager training per 84065(d)(3). (Reviewed 5 staff files) Proof of Tuberculosis testing only one staff had proof of TB 80066(a)(11) Medical Assessment Documentation 80066(a)(10) was missing in 3 of 5 staff records requiring indication of the presence of any health condition that would create a hazard to the person, clients or other staff members 80065(g)(2)(B) Criminal Record Statement - One staff was missing this document in their file 80066(a)(12)(A) Personnel evaluations were not present in any of the files per 84066(b)(6) Facility was cited for Personnel Records 80066(a) as records are required to be maintained for all employees and must have all required documentation. Facility was cited for 84065(i)(6) as not all staff had proof of First Aid/CPR as required. Documentation was provided to Ms. Good and exit interview conducted.


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
Licensing Program Analyst (LPA) Tamara Hill and Kevin Gaines, Community Care Licensing Division Representative made an unannounced annual inspection on 11/7/22 at 9: AM. LPA and Representative toured the facility inside and out and reviewed client records during the annual inspection. It was observed that there were three clients in care at the facility and there were two staff present and one teacher was present during the inspection. LPA and Representative observed that there were three dual occupancy client rooms in the facility but each of the clients currently are occupying a room. LPA observed that the smoke detectors and carbon monoxide detectors were functioning as required. LPA observed that the facility was clean and tidy during the inspection. LPA observed that the facility's water was not hot enough - measuring only 100 degrees Fahrenheit and measurements were taken in the kitchen and two client bathrooms. LPA observed that the facility is not providing allowances as required. LPA observed that the clients are not attending meetings related to needs and services or modifications of needs and services, which lends to clients not having an opportunity to have a voice in their treatment. LPA observed that one of the client bathrooms had towels hanging that could be used by other clients and common towels are not allowed. LPA observed that the rugs in the same bathroom slide and are not secure as required. LPA observed that the complaint/grievance policy is not posted as required. During client records reviewed, it was observed that the facility is not obtaining written documentation of the educational records for the clients in care. While only one client in the facility is taking psychotropic medication, there is no written authorization for this specific medication to be administered to client in care. Citations are attached and exit interview conducted with Ms. Bertolino and Michelle Good and documents provided along with appeal rights.

Deficiencies:
84068.2(b): Needs and Services Plan

(b) The needs and services plan shall identify the child's needs in the following areas

met_with: Bre Bertolino, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Tamara Hill made an unannounced case management inspection on 1/18/23 at 2: PM and met with Breana Bertolino, Administrator and Corey Montoya, Clinical Director. LPA discussed an incident report dated 1/2/23 in which a fight ensued in the facility and law enforcement was called to assist the facility in breaking up the incident. LPA discussed the documentation in the incident report that was submitted in that it appears that the facility discharged the youth without attempting to mitigate the removal of the youth and without a seven day notice to the placing agency per the program statement that was approved by the Department. LPA discussed with the administrator that when discharging a youth, the facility needs to provide a written seven day notice to the client's guardian and/or placing agency. LPA explained that there are circumstances when a youth should be discharged under emergency situations and that would be removal by law enforcement, hospitalization or other emergent situations. In this particular incident, LPA sees that a youth was discharged but there does not appear to be any other incidents involving this youth nor does it appear that the youth failed to calm down or take space after speaking with law enforcement. While discussing the incident with Ms. Bertolino, LPA was informed that there have been other issues of aggression with this youth but that it did not rise to the level of a report to Licensing. LPA informed the facility that providing all of the information and information utilized to reach the conclusion is necessary for the Department to understand and ensure that the facility is following their own program statement. Ms. Bertolino states that she will ensure that the incident reports moving forward are more comprehensive and have the information necessary that lead the facility to reach the conclusion that was reached. Exit interview conducted with Ms. Bertolino and Ms. Montoya.

met_with: Breana Bertolino, Administrator


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPAs) Mary Shelton and Monica Roberts made an unannounced annual inspection on 12/7/2023. LPA Mary Shelton and Monica Roberts toured the facility inside and out and reviewed staff and client records during the annual inspection. It was observed that there were six clients in care at the facility and there were four staff present and one teacher was present during the inspection. LPAs observed that there were four dual client rooms in the facility. There were two bedrooms with two clients and two bedrooms with single clients. LPA observed that the smoke detectors and carbon monoxide detectors were functioning as required. The LPAs observed that the facility was clean and maintained during the inspection. LPA observed that the facility's water was at required temperatures at all faucets within the home. LPAs observed the temperature of the home to be 72 degrees.LPA observed that the rugs are secure as required. All sharps and chemicals were properly secured. LPA observed that the complaint/grievance policy is posted as required. Exit interview was conducted with Ms. Bertolino.

met_with: Breana Bertolino, Residental Director


facility_name: NEWPORT ACADEMY-MAOLI

summary: Complaint Investigation - Substantiated

raw_content:
Narrative:
The facility has agreed to sign and return the LIC9099. Appeal Rights were provided and discussed, and Title 22 deficiencies were cited. An exit interview was conducted, and a copy of the report was sent to the facility.

Investigation Findings:
13On the above date, Licensing Program Analyst (LPA) Cheyenne McCambridge met with Residential Director Michelle Barnett regarding a complaint investigation at the Group Home. The purpose of the inspection was to deliver the findings for the above allegation. The investigation was conducted by CCIB Investigator Joseph Balarie. During the course of the investigation, the Investigator reviewed records and interviewed a Marin County Sheriff Deputy, youth, and staff. It was during these confidential interviews that it was confirmed that there had been inappropriate sexual activities between clients. Based on the information obtained, there is a preponderance of the evidence to prove that minors are engaging in inappropriate sexual activities while in care. Therefore, the above allegation is substantiated. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Isabel Diego LICENSING EVALUATOR NAME: Cheyenne McCambridge LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 21-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SANTA ROSA RO, NEOTOMAS AVENUE, STE. FACILITY NAME: NEWPORT ACADEMY-MAOLIFACILITY NUMBER: VISIT DATE: 05/15/2023

met_with: Laurel Chase


summary: Complaint Investigation - Substantiated

raw_content:
Investigation Findings:
13On the above date, Licensing Program Analyst (LPA) Cheyenne McCambridge met with Care Coordinator Mia Matthews regarding a complaint investigation at the Group Home. The purpose of the inspection was to deliver the findings for the above allegation. The investigation was conducted by CCIB Investigator Melissa Bennett. During the course of the investigation, the Investigator reviewed records and interviewed youth and staff. It was during these confidential interviews that it was confirmed that there had been inappropriate sexual activities between clients. Based on the information obtained, there is a preponderance of the evidence to prove that minors are engaging in inappropriate sexual activities while in care. Therefore, the above allegation is substantiated. Appeal Rights were provided and discussed, and Title 22 deficiencies were cited. An exit interview was conducted, and a copy of the report was sent to the facility. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Isabel Diego LICENSING EVALUATOR NAME: Cheyenne McCambridge LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 21-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SANTA ROSA RO, NEOTOMAS AVENUE, STE. FACILITY NAME: NEWPORT ACADEMY-MAOLIFACILITY NUMBER: 216890000

met_with: Mia Matthews


summary: Complaint Investigation - Unsubstantiated

raw_content:
Investigation Findings:
13On the above date, Licensing Program Analyst (LPA) Cheyenne McCambridge met with Residential Manager Hope Hurst regarding a complaint investigation at the Group Home. The purpose of the inspection was to deliver the findings for the above allegation. During the course of the investigation LPA McCambridge conducted confidential interviews, conducted record reviews, and reviewed documentation. Based on interviews, record reviews, and documentation the facility took appropriate actions and supervision of clients. This department has investigated the allegations, and although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the above occurred; therefore, the above allegations are Unsubstantiated. Appeal Rights were discussed, and no deficiencies were cited. An exit interview was conducted with Hope Hurst and a copy of the report was left at the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Isabel Diego LICENSING EVALUATOR NAME: Cheyenne McCambridge LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

met_with: Hope Hurst

complaint_status: unsubstantiated


raw_content:
Investigation Findings:
13On Wedensday, June 11, 2025 at 11AM, Licensing Program Analyst (LPA) Mariah Hawkins conducted an unannounced complaint investigation visit at the facility. LPA met with Residential Supervisor Starr Williams and informed of the purpose of the visit. The purpose of the visit was to deliver findings for the investigation of the above allegations. Based on confidential observations, interviews, and record review, one interview or reviewed record was found supporting the allegations, and six interviews or reviewed records were found either not supporting or contradicting the allegations. During the investigation, LPA reviewed staff training and discussed with facility management to ensure the facility continues to provide all staff training on boundaries, client rights, and mandated reporting. Although the allegations may have happened or are valid, based on LPA's observations and interviews, there is not a preponderance of the evidence to prove the alleged violations did or did not occur. Therefore, the allegations are Unsubstantiated. An exit interview was conducted, and a copy of this report and the licensee's appeal rights were provided to Residential Supervisor Starr Williams. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Isabel Diego LICENSING EVALUATOR NAME: Mariah Hawkins LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

met_with: Residential Supervisor Starr Williams


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Cheyenne McCambridge conducted an unannounced inspection to the facility for the purpose of conducting an Annual/Required inspection. LPA McCambridge met with Residential Supervisor GeorgiaMae Wallace and toured the facility, inside and out. The facility is clean, safe, sanitary, and in good repair. Front and backyard are safe and free from hazards. All passageways are unobstructed. There is no bodies of water or firearms on the property. All bedrooms have adequate closet and drawer space. The home is maintained at a comfortable temperature. Sharps, medications, toxins, and cleaning solutions are locked. There are carbon monoxide and smoke detectors throughout the facility. There were operable fire extinguishers posted throughout the facility. There are complete first-aid kits located in the facility. The facility understands that the hot water temperature must be maintained within the regulation range of 105 - 120 degrees. Required documents are posted. Staff and client files were reviewed and are current and complete with required documents. The group home is licensed to serve six clients ages 12-17. The home operates within the capacity and limitations of the license. There are currently 6 youth in placement at this location. No Title 22 deficiencies cited this date. Exit interview conducted a copy of the report was left at the facility.

met_with: GeorgiaMae Wallace


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Cheyenne McCambridge conducted an unannounced inspection to the facility for the purpose of conducting an Annual/Required inspection. LPA McCambridge met with Administrator Laurel Chase and toured the facility, inside and out. The facility is clean, safe, sanitary, and in good repair. Front and backyard are safe and free from hazards. All passageways are unobstructed. There is no bodies of water or firearms on the property. All bedrooms have adequate closet and drawer space. The home is maintained at a comfortable temperature. Sharps, medications, toxins, and cleaning solutions are locked. There are carbon monoxide and smoke detectors throughout the facility. There were operable fire extinguishers posted throughout the facility. There are complete first-aid kits located in the facility. The facility understands that the hot water temperature must be maintained within the regulation range of 105 - 120 degrees. Required documents are posted. Staff and client files were reviewed and are current and complete with required documents. The group home is licensed to serve six clients ages 12-17. The home operates within the capacity and limitations of the license. There are currently 6 youth in placement at this location. No Title 22 deficiencies cited this date. Exit interview conducted a copy of the report was left at the facility.


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Cheyenne McCambridge conducted an unannounced inspection to the facility for the purpose of conducting an Annual/Required inspection. LPA McCambridge met with Administrator Julia Byrum and toured the facility, inside and out. The facility is clean, safe, sanitary, and in good repair. Front and backyard are safe and free from hazards. All passageways are unobstructed. There is no bodies of water or firearms on the property. All bedrooms have adequate closet and drawer space. The home is maintained at a comfortable temperature. Sharps, medications, toxins, and cleaning solutions are locked. There are carbon monoxide and smoke detectors throughout the facility. There were operable fire extinguishers posted throughout the facility. There are complete first-aid kits located in the facility. The facility understands that the hot water temperature must be maintained within the regulation range of 105 - 120 degrees. Required documents are posted. Staff and client files were reviewed and are current and complete with required documents. The group home is licensed to serve six clients ages 12-17. The home operates within the capacity and limitations of the license. There are currently 5 youth in placement at this location. No Title 22 deficiencies cited this date. Exit interview conducted a copy of the report was left at the facility.

met_with: Julia Byrum


summary: Facility Evaluation

raw_content:
Narrative:
On 3/3/25, Licensing Program Analyst (LPA) Celeste Aparicio made an unannounced visit to the facility to conducted a case management inspection. LPA met with Residential Manager Hope Hurst and informed the Residential Manager on the purpose of the visit. The purpose of the visit was to discuss a submitted incident report regarding a participant bringing contraband on the grounds and facility contact information. During the inspection, LPA obtained additional information about the incident, documentation, and conducted one confidential interview. No deficiencies have been found during this visit. An exit interview was conducted, and a copy of this report was left with Residential Manager Hope Hurst , whose signature on this form confirms receipt.

met_with: Residential Manager, Hope Hurst


facility_name: NEWPORT ACADEMY-OASIS

summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
The allegations have not met the preponderance of doubt, and therefore the allegations that staff did not intervene when a youth resident was being physically assaulted by another youth and staff did not intervene when youth resident was being sexually assaulted by another youth are deemed unsubstantiated. LPA conducted an exit interview with Alvaro Zambrano, Residential Supervisor at 4:00PM whose signature confirms the receipt of this document.

Investigation Findings:
13On 11/14/2023 at 3:40PM, Licensing Program Analyst (LPA) Selena Hood conducted an unannounced visit to the licensed facility. The purpose of this visit was to deliver the findings for the listed allegations. LPA met with Alvaro Zambrano, Residential Supervisor. During the course of the investigation, LPA conducted eight confidential interviews from 6/27/2023 through 11/08/2023. LPA reviewed the childrens' files, daily logs, incident reports, and Contra Costa County Sheriff's Office report. Based on record review of the police report, there was not sufficient evidence from the law enforcement investigation to substantiate sexual or physical assault in the facility. Per confidential interviews, there were inconsistent statements regarding whether the assault occurred. Based on confidential interviews of three clients, all clients expressed that staff had done 15-minute checks during the night-time which is consistent with the facility's program statement. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Helga Wong LICENSING EVALUATOR NAME: Selena Hood LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 14-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SAN BRUNO ASC, TRAEGER AVE., SUITE FACILITY NAME: NEWPORT ACADEMY-OASISFACILITY NUMBER: VISIT DATE: 11/14/2023

Allegations:
- UnsubstantiatedEstimated Days of Completion: Unsubstantiated Estimated Days of Completion: Unsubstantiated Estimated Days of Completion:

met_with: Alvaro Zambrano


summary: Complaint Investigation - Unsubstantiated - 3 allegations

raw_content:
Investigation Findings:
13On Friday, 11/15/2024 at 11: AM Licensing Program Analyst (LPA) Shikya Belfield conducted an unannounced inspection at the above facility. The purpose of this inspection is to inform the facility representatives of the findings for the above complaint allegation. LPA met with Administrator Janelle Bush and Care Coordinator Amanda Bradbury, who assisted with the inspection. Based on confidential interviews conducted and supportive documentation to include but not limit, staff schedule, client schedule, needs and services plans, and safety plans, there were inappropriate interactions between clients that made one client feel uncomfortable. When reported to staff, appropriate actions were taken to address the concerns of the client. It was also confirmed that some of these interactions were not observed by staff due to taking place in private areas away from staff view. The preponderance of the evidence has not been met for a violation of lack of supervision. Therefore this allegation Unsubstantiated. There no violations cited during this inspection. An exit interview was conducted and copy of this report was left with Administrator Janelle Bush. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Isabel Diego LICENSING EVALUATOR NAME: Shikya Belfield LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 1

Allegations:
- UnsubstantiatedEstimated Days of Completion:
- Unsubstantiated Estimated Days of Completion:
- Unsubstantiated Estimated Days of Completion: 90

met_with: Janelle Bush


raw_content:
Narrative:
Based on confidential interviews and record review of an internal investigation, multiple clients had alleged that C3 and C4 had sexual interactions in the living room while one staff was in the kitchen and one staff was in the staff office. Based on confidential interview, LPAs' observations, and the facility sketch, there were no walls or obstructions between the kitchen and the living room. Based on record review of staff training, staff involved with the incidents had training on client supervision. Based on the behavioral intervention plans, warning signs were indicated to identify sexualized behaviors for C4. Based on confidential interviews, multiple staff stated in seeing warning signs of boundary violations between C3 and C4 prior to the alleged sexual incident. Based on the consistency of allegations made in confidential interviews and record review, the allegation that staff did not prevent minors from engaging in inappropriate sexual interactions while in care has met the preponderance of doubt. This poses an immediate risk to the health, safety, and/or personal rights of clients in care. LPA delivered a Type A citation under 80078(a) Responsibility for Providing Care and Supervision. LPAs delivered appeal rights and conducted an exit interview with Elizabeth Jimenez, Residential Supervisor whose signature confirms the receipt of this document.

Investigation Findings:
13On 5/21/2025 at 1:20 pm, Licensing Program Analysts (LPAs) Mona Lam and Hanako Primer conducted an unannounced inspection to the licensed facility. The purpose of this inspection was to deliver the findings for the listed allegation. LPAs met with Elizabeth Jimenez, Residential Supervisors. During the course of the investigation, LPAs conducted 14 confidential interviews. LPA Lam reviewed the behavioral intervention plans, staff member training, clients' treatment plans, map of the facility, and pertinent incident reports. Based on confidential interviews and incident reports, multiple clients and staff had alleged that C4 and C7 were involved with a sexual incident at the facility. As a result of the sexual incident, C7 was transferred, while C4 remained. In addition, the facility created behavioral intervention plans for C4 and C7 to prevent the incident from reoccurring. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Joel Segura LICENSING EVALUATOR NAME: Mona Lam LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 14-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SAN BRUNO RO, TRAEGER AVE., SUITE FACILITY NAME: NEWPORT ACADEMY-OASISFACILITY NUMBER: VISIT DATE: 05/21/2025

Allegations:
- SubstantiatedEstimated Days of Completion: Estimated Days of Completion: Estimated Days of Completion: UnsubstantiatedEstimated Days of Completion: Unsubstantiated Estimated Days of Completion: Unsubstantiated Estimated Days of Completion:


summary: Facility Evaluation

raw_content:
Narrative:
At 10:45AM, Licensing Program Analyst (LPA) Madeleine Fremont traveled to the home above for the purpose of conducting an unannounced combined Required Annual and Post-Licensing Inspection. LPA met with Director Princess Garcia and Program Manager Vandenbelt, who helped facilitate this inspection. Currently in care are five ambulatory clients. During this visit, LPA Fremont toured the home inside and out. The home is located at Johnston Road in Pleasanton, California. The home has a long private driveway off Johnston Road with an automatic gate at the bottom of the drive. The entry road opens up to a large front courtyard with a circle driveway and fountain, which is non-operable and has been turned into a large planter for flowers and cacti. The home is a two story structure with 4 client bedrooms, 4 client bathrooms, several staff and therapist offices, a kitchen, nurse's station, family room, dining room, gym, and a family visit room which is also utilized as a COVID-19 isolation room when needed. LPA toured the backyard first, exiting through sliding double doors located in the kitchen/breakfast area. These doors open out to a covered patio which has a stone fire pit and outdoor kitchen area. Neither the fire pit nore the outdoor kitchen area are used by clients or staff. The fire pit is surrounded by a low stone wall and has chairs for clients to sit outside. Down a small set of stairs from the patio, there is a pool, hot tub, and a tennis court further into the backyard. The pool and hot tub are covered by a netted cover and enclosed by a fence and gate with a self-latching closure. The tennis court is also surrounded by a fence with a self-latching gate. Next to the pool, there is a sitting area with hammocks, benches, and cushioned chairs for client leisure. The pool, hot tub, and sitting area are surrounded by a retaining wall and gate, and beyond this there is a landscaped area with cacti and trees that extends to the edge of the property, and is also enclosed by an iron fence. On the far side of the sitting area, there is a self-latching gate which remains locked. Beyond this gate, there are two permitted sheds which are used as therapists offices, and beyond these are the air conditioning units and natural gas storage tanks, which are also beyond locked fences and remain inaccessible to clients. From this area, there is another gate that opens back out to the driveway, where there are two 2-car garages. The garage has been converted into a gym and art/recreation room for the clients to utilize during free time. LPA observed each client bedroom to be comfortably furnished with more than the required amount of space for each client to store personal belongings. In the hallway closet outside of the client bedrooms, LPA observed extra linens including bed sheets and towels. Through the front door of the home, there is a foyer which has a staff office, as well as a check-in station where visitors and staff can check their temperature and sign in. Also in this area, the facility license, accreditations, Medi-Cal certifications, floor plan, personal rights, grievance policy, emergency disaster plan, and all other required signage are posted on the wall above the check-in station. During this inspection, LPA Fremont reviewed 5 client files and 5 staff files. All files were complete with all required documentation. LPA inspected the nurse's station where client medications are stored, and observed a separate locked cabinet for each of the clients' medications. All psychotropic medications were accompanied by required documentation. The nurse's station is kept locked, and inaccessible to clients. First aid kits were observed in the kitchen, garage, and nurse's station. In the kitchen, LPA observed at least 2 days of perishable foods and at least 7 days of nonperishable foods. Facility menu was posted on the kitchen counter. Emergency food supply was observed in the kitchen pantry. Fire extinguishers were observed in the garage, kitchen, upstairs hallway, abnd backyard, and all were inspected and observed to be in working order. Smoke and carbon monoxide detectors were observed throughout the house, and were tested during this visit and found to be in working order. Gas and water shutoffs were located in the backyard of the house. At this time, no deficiencies were observed or cited. An exit interview was conducted, and a copy of this report was given to Program Director Princess Garcia, whose signature on this form confirms receipt. Signature on LIC809-C was not saved, but original signature on the LIC809 was recorded.

met_with: Director Princess Garcia and Program Manager Alex Vandenbelt


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst Britanee Windom and Licensing Program Manager Angela King conducted a case management inspection on 04/25/23 at 11: AM based on the number of relevant law enforcement contacts reported by the facility, pursuant to Health and Safety Code section 1538.7. During this inspection, 5 out of Direct Care Staff and 6 out of 6 youth files were reviewed. 2 out of Direct Care Staff and 6 out of 6 youth were interviewed.(See the Confidential Names List, LIC 811, April 25, 2023). The Plan of Operation including policies and procedures were reviewed. Based on the analysis of the confidential interviews and youth file review including the individualized safety plan and treatment plans, the licensee uses trauma informed and evidence based de-escalation and intervention techniques when staff is responding to the behavior of a youth residing in the facility. Interviews with youth and staff indicate the licensee prohibits calls or threats to call law enforcement as a form of discipline. LPA Windom and LPM King observed documentation of completed training on policies and procedures on when and how to involve law enforcement in response to an incident. Training records show staff have been trained on Emergency Intervention as required. The licensee is contacting law enforcement in accordance to their Emergency Intervention Plan when there is an immediate risk of serious harm to a child or others. There are no deficiencies cited at this time. A copy of this report was discussed and provided to Director Priscilla Hernandez.

met_with: Director Priscilla Hernandez


summary: Facility Evaluation

raw_content:
Narrative:
On 6/27/2023 at 11:55AM, Licensing Program Analyst (LPA) Selena Hood conducted an unannounced visit to the licensed facility. The purpose of this visit was to follow up with an incident report delivered to Community Care Licensing (CCL) on 6/23/2023. LPA met with Alvaro Zambrano, Residential Supervisor. LPA conducted three interviews. LPA reviewed the incident reports. Based on record review, two clients in care engaged in consensual kissing. Per record review and confidential interviews, staff became aware of the incident the day after the incident occurred. The Residential Supervisor conducted a workshop on boundaries and the individual youth were talked to. At the time of the incident, the two youth involved were roommates. After the facility was made aware of the incident, the youth were moved to separate rooms. LPA conducted an exit interview with Alvaro Zambrano, Residential Supervisor at 1:25PM whose signature confirms the receipt of this document.


summary: Facility Evaluation

raw_content:
Narrative:
On 8/29/2024 at 10:30AM, Licensing Program Analysts (LPAs) Mona Lam and Jasmine Cardeno conducted an unannounced visit to the licensed facility. The purpose of this visit was to conduct the required annual inspection. LPAs met with Tiffany St. Jean, Residential Supervisor. During this time of the visit, there are three clients in care, that are ambulatory in the facility. There are two staffs present during the initial visit, but during transitioning of shifts, there are currently three staffs on site, not including residential supervisor. LPAs conducted a site inspection of the facility. There are four client bedrooms with two bedrooms having two beds each. LPAs observed the house to be clean, tidy, and in good repair. LPAs observed two mouse traps in the kitchen. One is located on the floor, while the other one is located on the kitchen counter in a corner. Menu is posted on refrigerator door. Hot water temperature was 116.2 degrees Fahrenheit. The temperature inside the freezer is 0 degrees Fahrenheit. The temperature inside the refrigerator is 48 degrees Fahrenheit. Based on observation of the fridge thermometer and documentation of refrigerator's temperature, the licensee did not ensure that the internal temperature is less than 45 degrees Fahrenheit, which poses/posed a potential health, safety or personal rights risk to persons in care. LPAs delivered a Type B citation for California Code of Regulations, Title 22, 84076(c)(3) Food Service (Refer to LIC809-D). LPAs observed there to be a sufficient amount of fresh and non-perishable foods. LPAs observed fresh linens stored in storage closet. LPAs observed multiple fire and carbon monoxide detectors. LPAs also observed the posted license and children's rights. LPAs observed that medication, dangerous objects, and cleaning supplies are all kept locked in garage storage and underneath the kitchen sink. Two fireplaces were indicated in the facility, but were covered and not in use. LPAs toured the backyard, exiting through sliding double doors located in the kitchen/breakfast area. A pool is located in the backyard, where it is fenced off and is inaccessible to clients. LPAs reviewed the emergency disaster preparedness binder in addition to medication information and storage. LPAs observed five client files during the time, and Fausto Aramburo assisted during the inspection. During the review of the client files, client files did not indicate name, address and telephone number of dentist. LPAs delivered a Technical Violation for 80070(b)(7). During the review of client files, one client's file did not have receipts of purchases supporting the transactions in addition to having a documented signature per transaction. LPAs delivered a Technical Violation for 80026(h)(1)(A). LPAs conducted three confidential staff interviews and three confidential client interviews. Further record review is necessary in order to finish the annual inspection in addition to physical plant. LPA will return to finish conducting the inspection. During the time of the visit, one deficiency was cited and two technical violations were delivered. LPAs conducted an exit interview and delivered appeal rights page to Tiffany St. Jean, Residential Supervisor, at 6: PM whose signature confirms the receipt of this document.


summary: Facility Evaluation

raw_content:
Narrative:
On 09/04/24 at 10: AM, Licensing Program Analysts (LPAs) Mona Lam and Jonathan Medina conducted a visit to the licensed facility. The purpose of this visit was to conduct a case management continual annual inspection. There are three clients and four staff members during the time of the visit. LPAs met with Administrator Alvaro Zambrano and Residential Supervisor Tiffany St. Jean who helped with the inspection. LPAs conducted a walkthrough of the physical plant. LPA Medina checked the water valves outside. During the visit, the temperature of the facility is 73 degrees Fahrenheit upstairs. The temperature downstairs ranged from 68 to 72 degrees Fahrenheit. There is sufficient perishables and non-perishables food present in the facility. During the visit, LPAs inspected five staff files. Based on the review of staff files, there was no physical training documentation provided upon: prudent parent standard, job shadowing, within 7 calendar days of completion of the 8 hour training, recognition of early signs of illness, and storage and preservation of medications (including the storage of medications that requires refrigeration). Six (6) technical violations were delivered in accordance to the deficiency. The technical violations include: 84065(b)(1)(A), 84065(i)(1)(C)(4), 84065(i)(1)(D), 84065(i)(3)(M), 84065(i)(5), and 1565(a)(7)(E). During the time of the visit, LPAs had observed the training hours of the five staff members. Based on LPAs' observations of training hours and interview with administrator, the child care staffs did not complete a minimum of 20 hours of annual training. LPAs delivered a Type B citation for California Code of Regulations, Title 22, 84065(j)(1) Personnel Requirements (Refer to LIC809-D). One deficiency was cited during the time of the visit. LPA conducted an exit interview with an appeals rights page to Administrator Alvaro Zambrano. Administrator's signature confirms the receipt of this document.


facility_name: NEWPORT ACADEMY-REDWOOD

raw_content:
Narrative:
The following is a discussion of the allegations listed on the LIC 9099 in order: Although there were indications of sexual activity between clients C1 and C2, Inv Martinez was unable to determine if there was any lack of supervision on the part of the staff that allowed it to occur. LPA Bertoli was unable to determine if C1 was given medication without authorization, as consent forms were signed and there was no documentation of any other restrictions. C1 was discharged to parents, which is allowable under emergency circumstances without advanced notice. All 5 clients interviewed acknowledged that the facility discouraged phone use during the first 72 hours on the program, but they stated that they were allowed to use the facility phone. C1 made and received calls at the facility per her parent. Staff had discussion with youth that parent may want them to go to another facility, but there was no indication that staff misled youth. C1's parent indicated that she had sent a message to the youth the night before the discharge occurred and she didn't think she ever got it. There is a lack of evidence to make a determination as to whether a regulatory violation did occur. This department has investigated the allegations, and although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the above occurred; therefore, the above allegations are Unsubstantiated. Appeal Rights were provided and discussed, and no deficiencies were cited. An exit interview was conducted with Laurel Chace and a copy of the report was sent to the facility.

Investigation Findings:
13On the above date, Licensing Program Analyst (LPA) Brian Bertoli met with Administrator Laurel Chace regarding a complaint investigation at the Group Home. The purpose of the inspection was to deliver the findings for the above allegations. Due to circumstances related to COVID-19, the visit was conducted by Teams online. This investigation was conducted jointly by Investigator Jorge Martinez, who investigated the first allegation, and LPA Bertoli, who handled the remainder of the allegations. During the course of the investigation, LPA Bertoli and Inv. Martinez interviewed clients, staff, a parent, and reviewed documentation and reports. The parent of the youth who was the alleged victim (see LIC 811 dated 5/13/22) had indicated that they would provide emails, pictures, and text messages to corroborate the occurrence of the incidents, but none was provided despite multiple requests. Neither Inv Martinez or LPA Bertoli were able to interview either C1 or C2. (continued on LIC 9099-C) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Zaid Hakim LICENSING EVALUATOR NAME: Brian Bertoli LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 21-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, NEOTOMAS AVENUE, STE. FACILITY NAME: NEWPORT ACADEMY-REDWOODFACILITY NUMBER: VISIT DATE: 05/13/2022

met_with: Laurel Chace


raw_content:
Narrative:
There is a lack of evidence to make a determination as to whether a regulatory violation did occur. This department has investigated the allegations, and although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the above occurred; therefore, the above allegations are Unsubstantiated. Appeal Rights were provided and discussed, and no deficiencies were cited. An exit interview was conducted with Laurel Chace and a copy of the report was sent to the facility.

Investigation Findings:
13On the above date, Licensing Program Analyst (LPA) Cheyenne McCambridge met with Residential Director Michelle Barnett regarding a complaint investigation at the Group Home. The purpose of the inspection was to deliver the findings for the above allegation. The investigation was conducted by CCIB Investigator Joseph Balarie, who investigated the first allegation, and LPA McCambridge, who handled the second allegation. During the course of the investigation, LPA Bertoli and Inv. Balarie interviewed clients, staff, a Marin County Sheriff Detective, and reviewed documentation and reports. During confidential interviews it was determined that staff conduct regular checks throughout the night and the incident occurred during the time where night checks were not required. (continued on LIC 9099-C) UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Isabel Diego LICENSING EVALUATOR NAME: Cheyenne McCambridge LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 21-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SANTA ROSA RO, NEOTOMAS AVENUE, STE. FACILITY NAME: NEWPORT ACADEMY-REDWOODFACILITY NUMBER: VISIT DATE: 05/26/2023

met_with: Michelle Barnett


raw_content:
Narrative:
There was a change of leadership in March 2023, which one of the interviewees relayed has fixed the issue of not updating the schedule. Eight of eight individuals interviewed stated that there was at least one staff on site at all times. Per the facility's program statement, the facility protocol is to have one to two staff present at all times. Based on the confidential interviews and record review, the facility did have compliant staffing ratios. Per LPA's record review, the staff schedule was incomplete; however, interviewees stated that other staff had filled in on those days. The allegation that facility does not have adequate staffing may or may not be true. The allegation has not met the preponderance of doubt, and is therefore unsubstantiated. LPA conducted an exit interview with Nina Singh, Administrator at 1:34PM whose signature confirms the receipt of this document.

Investigation Findings:
13On 6/20/2023 at 12:14PM, Licensing Program Analyst (LPA) Selena Hood conducted an unannounced visit to the licensed facility. The purpose of this investigation was to conduct interviews and deliver the findings for the listed allegation. LPA met with Michelle Barnett, Program Director. LPA Cheyenne McCambridge initially informed the facility of the allegation on 4/19/2023. During the visit on 6/20/2023, LPA Hood conducted seven confidential interviews. LPA Hood conducted one interview regarding the investigation prior to the visit. LPA Hood also conducted a record review of the February 2023 to May 2023 staff schedule, facility program statement, and incident reports. Based on record review of the staff schedule, the schedule was incomplete for multiple days in February 2023 and early March 2023. Based on interview, two people interviewed stated that the schedule was not updated but that staff was called in to assist. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Helga Wong LICENSING EVALUATOR NAME: Selena Hood LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 21-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, FACILITY NAME: NEWPORT ACADEMY-REDWOODFACILITY NUMBER: VISIT DATE: 06/20/2023

Allegations:
- UnsubstantiatedEstimated Days of Completion: Unsubstantiated Estimated Days of Completion: Unsubstantiated Estimated Days of Completion:


raw_content:
Narrative:
There was a change of leadership in March 2023, which one of the interviewees relayed has fixed the issue of not updating the schedule. Eight of eight individuals interviewed stated that there were times that the facility had one staff member on shift. Of the eight interviews, four specified that this occurred during both day and night shifts. Per the facility's program statement, "There is at least two (2) awake staff or contractors in the facility at all times. There is always (2) Care Managers on at all times." Per LPA's record review, the staff schedule was incomplete; however, interviewees stated that other staff had filled in on those days. Based on the confidential interviews and record review, the facility did not comply with the staffing requirements listed in their program statement by having less than two staff present in the facility at all times. This poses an immediate health, safety, and/or personal rights risk to children in care. The allegation that facility does not have adequate staffing has met the preponderance of doubt, and is therefore substantiated. LPA delivered a Type A citation for California Title Code of Regulations, 80022(k) (see LIC809D). LPA conducted an exit interview and provided appeal rights to Michelle Barnett, Program Statement at 12:46PM whose signature confirms the receipt of this document.

Investigation Findings:
13On 7/12/2023 at 12:40PM, Licensing Program Analyst (LPA) Selena Hood conducted an unannounced visit to the licensed facility. The purpose of this investigation was to conduct interviews and deliver the findings for the listed allegation. LPA met with Michelle Barnett, Program Director. Program Director is currently acting as substitute administrator due to administrator departing from facility on 7/7/2023. LPA Cheyenne McCambridge initially informed the facility of the allegation on 4/19/2023. LPA conducted seven confidential interviews. LPA Hood also conducted a record review of the February 2023 to May 2023 staff schedule, facility program statement, and incident reports. Based on record review of the staff schedule, the schedule was incomplete for multiple days in February 2023 and early March 2023. Based on interview, two people interviewed stated that the schedule was not updated but that staff was called in to assist. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Helga Wong LICENSING EVALUATOR NAME: Selena Hood LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 21-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, FACILITY NAME: NEWPORT ACADEMY-REDWOODFACILITY NUMBER: VISIT DATE: 07/12/2023

Allegations:
- SubstantiatedEstimated Days of Completion: Estimated Days of Completion: Estimated Days of Completion:


raw_content:
Investigation Findings:
13On the above date, Licensing Program Analyst (LPA) Cheyenne McCambridge met with Residential Supervisor Diego Chavez regarding a complaint investigation at the Group Home. The purpose of the inspection was to deliver the findings for the above allegation. During the course of the investigation LPA McCambridge conducted six confidential interviews, conducted record reviews, and reviewed documentation. Based on interviews, record reviews, and documentation the facility has all required staff working at the facility and has followed proper intake prodocols. This department has investigated the allegations, and although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the above occurred; therefore, the above allegations are Unsubstantiated. Appeal Rights were discussed, and no deficiencies were cited. An exit interview was conducted with Laurel Chace and a copy of the report was sent to the facility. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Isabel Diego LICENSING EVALUATOR NAME: Cheyenne McCambridge LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of 3

met_with: Diego Chavez


summary: Complaint Investigation - Substantiated

raw_content:
Investigation Findings:
13This is an amended report due to LPA including information in the 9099 that did not pertain to this complaint. On the above date, Licensing Program Analyst (LPA) Cheyenne McCambridge met with Administrator Kimeeco Epps regarding a complaint investigation at the Group Home. The purpose of the inspection was to deliver the findings for the above allegation. During the course of the investigation LPA McCambridge conducted seven confidential interviews, conducted record reviews, and reviewed documentation. During confidential interviews and documetntion it was determined that the above allegations did happen. This poses an immediate health, safety, and/or personal rights risk to children in care. Based on the information obtained there is a preponderance of the evidence to prove the above allegations and is therefore substantiated. LPA delivered a Type A citation for California Title Code of Regulations, 84072(d)(11) (see LIC809D). Appeal Rights were discussed. An exit interview was conducted with Kimeeco Epps and a copy of the report was sent to the facility. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Isabel Diego LICENSING EVALUATOR NAME: Cheyenne McCambridge LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 21-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SANTA ROSA RO, NEOTOMAS AVENUE, STE. FACILITY NAME: NEWPORT ACADEMY-REDWOODFACILITY NUMBER: 216890001

met_with: Kimeeco Epps


summary: Complaint Investigation - Substantiated

raw_content:
Investigation Findings:
13On the above date, Licensing Program Analyst (LPA) Cheyenne McCambridge met with compliance manager Crystal Goodwin regarding a complaint investigation at the Group Home. The purpose of the inspection was to deliver the findings for the above allegation. The investigation was conducted by CCIB Investigator Juan Barajas. During the course of the investigation, the Investigator reviewed records and interviewed youth and staff. It was during these confidential interviews that it was confirmed that there had been inappropriate sexual contact between clients. Based on the information obtained, there is a preponderance of the evidence to prove that minors had engaged in inappropriate sexual activities while in care. Therefore, the above allegation is substantiated. Appeal Rights were provided and discussed, and Title 22 deficiencies were cited. An exit interview was conducted, and a copy of the report was left at the facility. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Isabel Diego LICENSING EVALUATOR NAME: Cheyenne McCambridge LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 21-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SANTA ROSA RO, NEOTOMAS AVENUE, STE. FACILITY NAME: NEWPORT ACADEMY-REDWOODFACILITY NUMBER: 216890001

met_with: Crystal Goodwin


summary: Facility Evaluation

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Narrative:
Licensing Program Analyst (LPA) Cheyenne McCambridge conducted an unannounced inspection to the facility for the purpose of conducting an Annual/Required inspection. LPA McCambridge met with Administrator Laurel Chase and toured the facility, inside and out. The facility is clean, safe, sanitary, and in good repair. Front and backyard are safe and free from hazards. All passageways are unobstructed. There is no bodies of water or firearms on the property. All bedrooms have adequate closet and drawer space. The home is maintained at a comfortable temperature. Sharps, medications, toxins, and cleaning solutions are locked. There are carbon monoxide and smoke detectors throughout the facility. There were operable fire extinguishers posted throughout the facility. There are complete first-aid kits located in the facility. The facility understands that the hot water temperature must be maintained within the regulation range of 105 - 120 degrees. Required documents are posted. Staff and client files were reviewed and are current and complete with required documents. The group home is licensed to serve six clients ages 12-17. The home operates within the capacity and limitations of the license. There are currently 6 youth in placement at this location. No Title 22 deficiencies cited this date. Exit interview conducted a copy of the report was left at the facility. client interviews were unable to be done due to clients being in sessions.


facility_name: NEWPORT ACADEMY-RIDGEVIEW

summary: Facility Evaluation

raw_content:
Narrative:
On September 28, 2022 at 1:42pm, Licensing Program Analyst (LPA) Adrian Mendez arrived unannounced at the facility to conduct an Annual/Random inspection of the facility. The facility was inspected inside and out with Program Manager Ellen Asquith. Bedrooms are arranged so that no more than two clients share a room, and there is one client per bed. There is adequate shelf and closet space for client's belongings. The bathrooms were clean and in good repair. The hot water in the kitchen sink was measured at 119.1 degrees, which is within regulatory requirements. All hazardous items have been properly made inaccessible. The medications were stored and locked in a medication room in the hallway. Cleansers/chemicals are locked and stored in a locked staff office. Sharp knives are inaccessible and stored in a locked staff office. The First Aid Kit is located in the medication room and contained all required supplies. The facility's smoke/carbon monoxide detectors in the hallways were checked and were operable. There are no guns or weapons in the facility as stated by Program Manager Ellen Asquith. The following required posted items were observed accessible to clients: Facility License, Grievance Procedures, Personal Rights, Visitation policies, Emergency Disaster Plan and current menu. The facility outside grounds was also inspected and it was observed to be clean and well maintained. There is a swimming pool located in the backyard of the facility which is made inaccessible with a pool cover. Emergency exits were free from obstruction. Due to time constraints and the need to complete client/staff interviews, and client/staff file reviews, this inspection will need to be continued at a later date. LPA discussed and reviewed the following inspection components; Operational Requirements, Emergency Disaster Preparedness, and the Emergency Intervention Plan. Cont. on 809-C Based on the facility inspection, and files reviewed there are no deficiencies found at this time. An exit interview was conducted, and a copy of this report was explained to Program Manager Ellen Asquith. Due to printer malfunction, this report will be emailed to Program Manager Ellen Asquith.

met_with: Ellen Asquith


summary: Facility Evaluation

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Narrative:
On September 29, 2022 at 10:13am, Licensing Program Analyst (LPA) Adrian Mendez arrived unannounced at the facility to conduct an Annual Continuation inspection of the Annual/Random inspection that began on 09/28/2022. LPA met with Program Manager Ellen Asquith, Director of Residential Services Amanda Seymour, and Human Resources Manager Wendy Cabrera. During the inspection, LPA reviewed nine staff files and five client files. A sample of five client files were reviewed during the inspection. All client files had the required documents per Title Regulations. All client files are maintained on a secured internet database. All the staff records are accessible electronically via a secured records portal. LPA reviewed 9 of 9 staff files. All the staff have met the training and qualification requirements per regulation requirements. Per a review of the Community Care Licensing Information System (LIS), all staff met DOJ/FBI criminal record clearances and Child Abuse Index Check requirements. Due to time constraints and the need to complete client/staff interviews, this inspection will need to be continued at a later date Based on the facility inspection, and files reviewed there are no deficiencies found at this time. An exit interview was conducted, and a copy of this report was explained to Director Amanda Seymour. Due to printer malfunction, this report will be emailed to Director Amanda Seymour.

met_with: Ellen Asquith, Amanda Seymour


summary: Facility Evaluation

raw_content:
Narrative:
On October 4, 2022 at 12:25pm, Licensing Program Analyst (LPA) Adrian Mendez arrived unannounced at the facility to conduct an Annual Continuation inspection of the Annual/Random inspection that began on 09/28/2022. LPA met with Program Manager Ellen Asquith. During the inspection, LPA conducted interviews with three facility staff and one client. Four clients declined to be interviewed. Based on the facility inspection, and interviews conducted, there are no deficiencies found at this time. An exit interview was conducted, and a copy of this report was explained to Program Manager Ellen Asquith. Due to printer malfunction, this report will be emailed to Program Manager Ellen Asquith.


summary: Facility Evaluation

raw_content:
Narrative:
On March 17, 2025, at 9: AM, Licensing Program Analyst (LPA) Stefanie Mutialu met with Compliance Specialist (CS), Whitney Rodgers and Residential Director, Amanda Seymour (AS). The Facility is licensed to serve six (6) ambulatory children ages 12-17 years old. The current census is five (5) children. The facility is three-bedroom, five-bathroom, one-story home. A physical plant inspection was completed with CS and included the following checks: three client bedrooms, four client bathrooms, two staff bathrooms, kitchen, living room, dining area, staff office, therapy office, care coordinator office, associate clinical director's office, program manager's office, family therapy room, two clinical offices, storage office, laundry area, and recreation room/garage. LPA observed the interior of the facility is in the process of being painted. Per CS painting only takes place while clients are away at school. All required forms are posted including Grievance Procedures, Visitation Policies, Personal Rights form, and Foster Care Ombudsman poster, the Emergency Disaster Plan was also posted. Clients' medications were observed to be inaccessible and stored in medication room. Facility grounds are clean and free of debris. There is adequate indoor and outdoor activity space. All facility fire extinguishers are properly charged and serviced on 03/07/2025. Fire clearance inspection was completed on 02/05/2025 and LPA received a copy of the approved Fire Clearance to place in facility file. Licensee maintains an adequate supply of perishable and non-perishable foods to prepare the items on the posted menu. LPA observed a minimum seven-day non-perishable and two-day perishable supply of food. ***Continued on Page 2*** Individual beds were observed with clean linens, pillows, comforters, and mattress in good repair. Two bedrooms contain two twin beds. One bedroom contains one twin bed and one full size bed The facility has two client bathrooms. The water temperature was tested in one bathroom with a measure of 114.3 degrees Fahrenheit the appropriate range of 105 degrees to 120 degrees Fahrenheit. All client files are stored and maintained on a secure internet database. LPA reviewed five client files to ensure clients had all required documents per Title 22. LPA reviewed five client medication records. LPA conducted two staff interviews and two client interviews. Due to time constraints LPA will return on another day to review staff files. No deficiencies cited. Per facility staff, no firearms or weapons are allowed in the facility. The licensing fee payments are current. An exit interview was conducted, and a copy of this report and appeal rights were discussed and provided to Monica Garcia. A copy of this report will be placed in the facility file.

met_with: Compliance Director, Whitney Rodgers


summary: Facility Evaluation

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Narrative:
On March 27, 2025, at 3: PM, Licensing Program Analyst (LPA), Stefanie Mutialu continued the unannounced annual inspection, which was started on March 19 ,2025. LPA met with Program Manager , Monica Garcia. LPA reviewed five staff (S1-S5) records. No deficiencies cited. An exit interview was conducted, and a copy of this report and appeal rights were discussed and provided to Monica Garcia. A copy of this report will be placed in the facility file. *Due to technical difficulties LPA returned the next day for signature.

met_with: Program Manager, Monica Garcia


summary: Facility Evaluation

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Narrative:
On April 2, 2026, at 9: AM, Licensing Program Analyst (LPA) Gilbert Marquez arrived unannounced at the facility to conduct an annual inspection. The facility was inspected inside and out with Amanda Seymour, Executive Director. Facility is licensed to serve six ambulatory clients, age groups 7-12 or 12-17 years of age. The facility is current with their licensing fees. The census was zero clients at the time of the inspection. The facility is a three-bedroom, five-bathroom, one-story home. A physical plant inspection included the following checks: kitchen, living room, dining area, two therapy offices, five staff offices, nursing station, and gym and laundry area converted from car garage. Bedrooms are arranged so that no more than two clients share a room, and there is one client per bed. There is adequate shelf and closet space for client's belongings. All the required linens were on every bed. The three bedrooms and five bathrooms are arranged the following way: Bedroom #1 will sleep two clients, and has two twin beds, drawer space, and closet. Bedroom #2 will sleep two clients and has two twin beds, drawer space, and closet. Bedroom #3 will sleep two clients and has two twin beds, drawer space, and closet. Bathroom #1 is connected with bedroom #1 and #2, and has a toilet, sink, and shower. Bathroom #2 is connected with bedroom #3, and has a toilet, sink, and shower. **Continued on LIC809C** **Continued from LIC809** Bathroom #3 is located in the hallway and is used by clients, and has a toilet, and a sink. Bathroom #4 is connected to the therapy office and has a toilet, sink, shower and non-functional tub. Bathroom #5 is connected to the nursing station, and has a toilet, sink, and shower. The hot water measured in bathroom #1 and bathroom #2 at 112.3 degrees Fahrenheit, which is in the regulatory range of 105 degrees to 120 degrees Fahrenheit. All hazardous items have been properly made inaccessible to clients. The medications are to be stored and locked in a cabinet in the locked medication room in the hallway. Cleansers and chemicals are locked and stored in two places, one in the kitchen and one in the hallway supply closet. Sharp knives are inaccessible and stored in a locked staff office. The First Aid Kit is located in the medication room and contains all required supplies. There are no guns or weapons in the facility as stated by Amanda Seymour. The facility's smoke and carbon monoxide detectors in the hallways and bedrooms were checked and were operable. The facility has several fire extinguishers on campus and were all maintained by Cintas company. The Health and Safety binder included fire drills and disaster drills completed last year and meets standards. The Emergency Disaster plan was reviewed this year by Amanda Seymour. There was a sample menu posted in the kitchen. The facility had an adequate supply of perishable and non-perishable foods to prepare the items on the posted menu. LPA observed a minimum seven-day non-perishable and two-day perishable supply of food. The following required posted items were observed accessible to clients: Facility License, Grievance Procedures, Personal Rights, and Emergency Disaster Plan. The facility outside grounds was also inspected and it was observed to be clean and well maintained. Emergency exits were free from obstruction. There is a gym with weights and a pool table in the converted garage. There is a pool located in the backyard that is enclosed by a 5-foot fence that has a self-locking mechanism and meets Title 22 regulations. LPA interviewed one staff and there are no clients in care. Based on the facility inspection, interview, and file reviewed there are no deficiencies found at this time. An exit interview was conducted, and a copy of this report was explained and given to Amanda Seymour, Executive Director.

met_with: Amanda Seymour, Executive Director


summary: Facility Evaluation

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Narrative:
On May 11, 2026, at 8: AM, Licensing Program Analyst (LPA), Jacqueline Garcia arrived unannounced to the facility and met with Madison Holstein, Behavioral Health Specialist, regarding a case management inspection at the facility. The purpose of the inspection is to obtain additional information regarding incident that occurred at the facility on 05/06/26. Community Care Licensing received a Serious Incident report informing the department information regarding incident involving client listed on the confidential names list (LIC 811) dated 05/11/2026. LPA conducted a safety check of the facility, and no deficiencies were observed. LPA conducted staff and client interviews. Additionally, LPA conducted a records review to further assist with the case management. This case management is being extended to further investigate. LPA will return to the facility to provide the outcome of this case management at a later time. LPA discussed this report and provided a copy of this report along with LIC 811 to Madison Holstein-Behavioral Health Specialist.


facility_name: NEWPORT ACADEMY-ROGERS

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Narrative:
Confidential interviews revealed that staff offered verbal interventions to C1. Confidential interviews also revealed that clients hide self-harming from staff which does not allow staff opportunity to intervene. Based on confidential interviews, and records reviewed, the allegation that staff did not follow emergency intervention plan to prevent minor from self-harming, may have occurred, however is not supported or proven by evidence. Therefore, the allegation is unsubstantiated at this time. Exit interview was conducted and a copy of this report, along with the appeal rights were explained and provided to Program Manager Claudia Jaimes.

Investigation Findings:
13On June 2, 2022, at 12:17pm, Licensing Program Analyst (LPA) Adrian Mendez arrived unannounced to the facility and met with Program Manager Claudia Jaimes of Newport Academy-Rogers to discuss the investigative finding for the allegation noted above. LPA conducted an inspection with the facility on November 22, 2021, at 3:11pm. No deficiencies were noted. During the investigation, LPA interviewed one Group Home staff (S1), and four clients (C1, C2, C5, C6). LPA also reviewed one Serious Incident Report (SIR) dated 10/03/2021, and the facility's Program Statement. On November 19, 2021, the Department received an allegation that staff did not follow emergency intervention plan to prevent minor from self-harming. It was reported that while residing at the facility, C1 would self-harm more than before while at home. It was also reported that staff would try and use verbal interventions to address the self-harming due to the facility having a "hands off" policy. Confidential interviews revealed that facility staff protocol is to offer coping skills and verbal interventions to address clients self-harming. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Adrian Mendez LICENSING EVALUATOR SIGNATURE: I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC9099 (FAS) - (06/04)Page: 1 of Control Number 22-CR- STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont)CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CCLD Regional Office, THE CITY DR., SUITE FACILITY NAME: NEWPORT ACADEMY-ROGERSFACILITY NUMBER: VISIT DATE: 06/02/2022

Allegations:
- UnsubstantiatedEstimated Days of Completion: Unsubstantiated Estimated Days of Completion: Unsubstantiated Estimated Days of Completion:

met_with: Claudia Jaimes


summary: Facility Evaluation

raw_content:
Narrative:
On October 6, 2022 at 10:40am, Licensing Program Analyst (LPA) Adrian Mendez arrived unannounced at the facility to conduct an Annual/Random inspection of the facility. The facility was inspected inside and out with Residential Supervisors Diana Mendoza, and Amy Bautista, and Director Amanda Seymour. Bedrooms are arranged so that no more than two clients share a room, and there is one client per bed. There is adequate shelf and closet space for client's belongings. The bathrooms were clean and in good repair. The hot water one of the client bathrooms was measured at 116.7 degrees, which is within regulatory requirements. All hazardous items have been properly made inaccessible. The medications were stored and locked in a medication room in the hallway. Cleansers/chemicals are locked and stored in a locked supply closet. Sharp knives are inaccessible and stored in a locked drawer in the kitchen. The First Aid Kit is located in the medication room and contained all required supplies. The facility's smoke/carbon monoxide detectors in the hallways were checked and were operable. There are no guns or weapons in the facility as stated by Residential Supervisor Diana Mendoza. The following required posted items were observed accessible to clients: Facility License, Grievance Procedures, Personal Rights, Visitation policies, Emergency Disaster Plan and current menu. The facility outside grounds was also inspected and it was observed to be clean and well maintained. There are no pools or bodies of water located on the facility grounds. Emergency exits were free from obstruction. Due to time constraints and the need to complete client/staff interviews, and staff file reviews, this inspection will need to be continued at a later date. LPA discussed and reviewed the following inspection components; Operational Requirements, Emergency Disaster Preparedness, and the Emergency Intervention Plan. During the inspection, LPA conducted interviews with one staff. Cont. on 809-C A sample of five client files were reviewed during the inspection. All client files had the required documents per Title Regulations. All client files are maintained on a secured internet database. Based on the facility inspection, interviews conducted, and files reviewed there are no deficiencies found at this time. An exit interview was conducted, and a copy of this report was explained to Director Amanda Seymour. Due to printer malfunction, this report will be emailed to Director Amanda Seymour.

met_with: Diana Mendoza, Amy Bautista, Amanda Seymour


summary: Facility Evaluation

raw_content:
Narrative:
On October 14, 2022 at 11:07am, Licensing Program Analyst (LPA) Adrian Mendez arrived unannounced at the facility to conduct an Annual Continuation inspection of the Annual/Random inspection that began on 10/06/2022. LPA met with Program Manager Claudia Jaimes, and Human Resources Manager Wendy Cabrera. During the inspection, LPA reviewed 10 staff files. LPA also conducted interviews with two staff and two children. Staff records are maintained at an off-site location (#306004843). Staff records are also accessible electronically via a secured records portal. LPA reviewed 10 staff files. All the staff have met the training and qualification requirements per regulation requirements. Per a review of the Community Care Licensing Information System (LIS), all staff met DOJ/FBI criminal record clearances and Child Abuse Index Check requirements. Based on the facility inspection, interviews conducted, and files reviewed, there are no deficiencies found at this time. An exit interview was conducted, and a copy of this report was explained to Program Manager Claudia Jaimes. Due to printer malfunction, this report will be emailed to Program Manager Claudia Jaimes.


summary: Facility Evaluation

raw_content:
Narrative:
On March 27, 2025, at 9: AM, Licensing Program Analyst (LPA) Stefanie Mutialu met with Cleaning Staff, Idalina Jimenez and Program Manager Monica Garcia for the purpose of conducting an annual inspection of the facility. The Facility is licensed to serve six (6) ambulatory children ages 12-17 years old. The current census is six children. The facility is a three-bedroom, three-bathroom, one-story home. A physical plant inspection was completed with the Program Manager and included the following checks: three client bedrooms, two client bathrooms, one staff bathroom, kitchen, living room, dining area, two therapy offices, care coordinator office, family therapy room, group room, laundry area, and backyard horse stable. All required forms are posted including Grievance Procedures, Visitation Policies, Personal Rights form, and Foster Care Ombudsman poster, the Emergency Disaster Plan was also posted. Clients' medications were observed to be inaccessible and stored in medication room. LPA observed one Ring Doorbell camera at the facility in the front of the home. Facility grounds are clean and free of debris. There is adequate indoor and outdoor activity space. Facility fire extinguishers are properly charged and serviced on 03/07/2025. Fire clearance inspection was completed on 02/05/2025 and LPA received a copy of the approved Fire Clearance to place in facility file. Licensee maintains an adequate supply of perishable and non-perishable foods to prepare the items on the posted menu. LPA observed a minimum seven-day non-perishable and two-day perishable supply of food. ***Continued Page 2*** Individual beds were observed with clean linens, pillows, comforters, and mattress in good repair. Two bedrooms contain two twin beds. One bedroom contains one twin bed and one full size bed The facility has two client bathrooms. The water temperature was tested in one bathroom with a measure of 115.6 degrees Fahrenheit the appropriate range of 105 degrees to 120 degrees Fahrenheit. All client files are stored and maintained on a secure internet database. LPA reviewed five client files and five staff files to ensure files met all required documents per Title 22. LPA reviewed five client medication records. LPA conducted two staff interviews with S1 and S2. LPA conducted two client interviews with C1 and C2. No deficiencies cited. Per facility staff, no firearms or weapons are allowed in the facility. The licensing fee payments are current. An exit interview was conducted, and a copy of this report and appeal rights were discussed and provided to Monica Garcia. A copy of this report will be placed in the facility file.


summary: Facility Evaluation

raw_content:
Narrative:
On May 8, 2025, at 8: AM, Licensing Program Analyst (LPA) Jacqueline Garcia conducted an unannounced case management inspection at the facility and met with Residential Supervisor, Benjamin Tschirhart, regarding two incident reports (IR's) that occurred on 4/5/25 and 4/8/25. The department received the IR's on 5/6/25. The incident involved medication errors involving staff (S1& S2) and clients (C1 & C2). LPA reviewed staff and client records and obtained records. Community Care Licensing (CCL) was not provided IR's within the required time frame. The Group home facility is being cited for violation of Title General Licensing Requirements, Section Reporting Requirements. An exit interview was conducted, appeal rights explained, and a copy of this report along with LIC 811 was reviewed and given to Residential Supervisor, Benjamin Tschirhar.

met_with: Ben Tschirhart-Residential Supervisor