facility_name: NEWPORT ACADEMY - HAPPY VALLEY

raw_content:
Narrative:
Per the Performance Improvement Plan signed by S1 and Administrator, S1 was put on the plan due to the following behavior: "Demonstrates inappropriate responses/boundaries with clients (I.E., "Cussing at clients when they give pushback/do not follow redirection"). Based on the confidential interviews and record review, the allegations that staff used inappropriate language toward clients in care and staff did not treat clients with dignity and respect while in care have met the preponderance of doubt and therefore the allegation is substantiated. LPA delivered a Type B citation for California Code of Regulations Title 22 80072 (a)(1) (see LIC 9099D). LPA conducted an exit interview and provided appeal rights with Priscilla Hernandez, Administrator at 12:35PM. Documentation was sent for signature due to connection issues.

Investigation Findings:
13On 7/20/2023 at 12:14PM, 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 allegation. LPA Madeleine Fremont initially opened the investigation with the facility on 4/6/2023. During the course of the investigation, LPA Hood, LPA Fremont, and LPM Helga Wong conducted eleven confidential interviews. LPA Hood reviewed clients' treatments plans, staff performance improvement plan, and shift notes. Based on confidential interview, five interviews stated that S1 had cussed directed towards youth in care. There were inconsistencies in what exactly was said between the three interviewed. LPA was not able to interview the youth involved due to lack of parental permission. 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 14-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 - HAPPY VALLEYFACILITY NUMBER: 015650119

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

met_with: Priscilla Hernandez


state: CA

summary: Complaint Investigation - Unsubstantiated - 1 allegation

raw_content:
Narrative:
Based on confidential interviews and record review, the allegation that facility nurse made a threat to client may or may not be true. The allegation has not met the preponderance of doubt and is therefore unsubstantiated. No deficiencies were cited at this time. LPA conducted an exit interview with Priscilla Hernandez, Program Director at 12:01PM whose signature confirms the receipt of this document.

Investigation Findings:
13On 8/7/2023 at 11:57AM, 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 above allegation. LPA met with Priscilla Hernandez, Program Director. During the course of the investigation, LPA conducted eight confidential interviews. LPA reviewed C1's file, internal investigation notes, and the staff schedule. Based on confidential interviews, there were no witnesses to the alleged threat. Based on two interviews, the client involved had a history of making false allegations.The client involved is on an extended AWOL from home and was not available to interview. Based on record review, the internal investigation did not find conclusive evidence either way. 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 CCLD Regional Office, FACILITY NAME: NEWPORT ACADEMY - HAPPY VALLEYFACILITY NUMBER: VISIT DATE: 08/07/2023

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

report_type: Complaint Investigation

complaint_status: unsubstantiated


raw_content:
Narrative:
information. According to record review of one client's drug test that was administered on 5/15/2023, one client had test positive for marijuana. This client was admitted to the facility on 3/31/2023 and there were no records AWOLs at this point. Based on record review of treatment plans, all three clients involved had a goal of lessening substance abuse. Based on record review of the daily notes for 5/13/2023, three clients had gone on an outing with S1 due to the carbon monoxide detector being set off. Based on confidential interviews and record review of the incident report, S1 had taken the three clients in their personal car. Per confidential interviews and review of the facility protocols, staff members are prohibited from utilizing their personal cars to transport clients. Based on review of the staff schedule, S1 was one of the two staff members on shift on 5/13/2023 from 3PM-11PM. According to internal investigation and two confidential interviews, S1 had allowed a client to drive their personal car while other youth were in the car. This client did not have their driver's license. Based on record review and confidential interviews the allegation that staff member provided marijuana to minor in care has met the preponderance of doubt and is therefore substantiated. This poses an immediate threat to the health, safety, and/or personal rights of clients in care. LPA delivered a Type A citation for Health and Safety Code 1568.092 (see LIC809D). Based on record review and confidential interviews the allegation that staff member took minor in care on unauthorized outings has met the preponderance of doubt and is therefore substantiated. This poses an immediate threat to the health, safety, and/or personal rights of clients in care. LPA delivered a Type A citation for California Code of Regulations Title 22 84074(d). Based on record review and confidential interviews the allegation that staff member allowed minor in care to behave in an unsafe manner while on an outing has met the preponderance of doubt and is therefore substantiated. This poses an immediate threat to the health, safety, and/or personal rights of clients in care. LPA delivered a Type A citation for California Code of Regulations Title 22 84065.2(b)(1) (see LIC809D). LPA Hood conducted an exit interview with Brad Lovegren, Associate Clinical Director at 1:35PM and provided appeal rights. The allegation has not met the preponderance of doubt and is therefore unsubstantiated. No deficiencies were cited in regards to this allegation. LPA conducted an exit interview with Brad Lovegren, Associate Clinical Director at 1:37PM whose signature confirms the receipt of this document.

Investigation Findings:
13On 8/31/2023 at 12:40PM, 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 Brad Lovegren, Associate Clinical Director. During the course of the investigation, LPA Hood, LPA Madi Fremont, and Licensing Program Manager (LPM) Helga Wong conducted sixteen interviews with fourteen participants. LPA Hood reviewed the shift notes for 5.13.2023, treatment plans for three clients, staff schedule, pertinent incident reports, drug test results for one client, and S1's Guardian clearance. Based on confidential interviews, one interviewee was a primary witness to a staff member providing clients marijuana and nicotine vape pens. According to confidential interviews, seven of the other participants were aware that S1 had provided marijuana vape pens to the clients in care. Of the three clients involved in the allegations, two clients were unavailable to speak due to lack of parental authorization and lack of contact 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 14-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 - HAPPY VALLEYFACILITY NUMBER: VISIT DATE: 08/31/2023

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:

met_with: Brad Lovegren


summary: Complaint Investigation - Substantiated

raw_content:
Narrative:
The purpose of this meeting was to deliver the finding for the listed allegations. LPA Hood initially informed the facility of the listed allegation on 9/21/2023. LPA Hood received the following documents: C1's service plan, C1's shift notes, C1's face sheet, staff schedule, S1's training, S1's clearance information, and S1's personal information. LPA Hood conducted one confidential interview. During the course of the investigation, Investigations Branch Investigator Eddie Phung had conducted eight interviews from 9/29/2023 to 11/14/2023. Investigator Phung also reviewed the staff schedule, S1's file, C1's file, written staff testimony, and the Alameda County Sheriff's Office police report. Based on confidential interviews and record reviews, the allegation of sexual abuse had maintained consistent through multiple interviews. Four confidential interviews reported that they had viewed concerning behavior between one staff and one client [S1 and C1]. Based on one firsthand account and record review, on 9/1/2023 one staff member viewed S1 and C1 holding hands with each other. Based on record review, the facility had documented that multiple staff had concerns with S1's boundary-crossing in the facility, especially pertaining to C1. According to confidential interviews, during one of their shifts S1 had relieved the night shift early and texted the other morning shift person to inform them when they would be arriving to the facility. Based on Investigator Phung's record review, S1's early arrival at the facility had been logged on the staff timesheet. The allegations were also investigated by the Alameda County Sheriff's Office. Investigator Phung and LPA Hood reviewed the police report, the charges were sent to the Alameda County District Attorney's Office for review of criminal charges. Based on the confidential interviews and record review, the allegation that staff sexually abused a youth in care has met the preponderance of doubt and is therefore substantiated. Community Care Licensing (CCL) delivered a Type A citation for California Health and Safety Code 1568.092(a)(2) (see LIC 9099D). LPA Hood delivered appeal rights and created a plan of correction with the facility representative. LPA conducted an exit interview with Crystal Goodwin, Compliance Officer at 12:20PM. This meeting was conducted virtually, this report will be sent virtually for signature.

Investigation Findings:
13On 12/7/2023 at 12:10, Licensing Program Analyst (LPA) Selena Hood, LPA Brenda Rodriguez, Licensing Program Manager (LPM) Helga Wong, and Regional Manager (RM) Nelson Martinez conducted a meeting with the following attendees: Kristina Schmenitzer, Regional Executive Director Annie Gendaszek, Associate Vice President of Compliance and Licensing Heather Hagen, Executive Director of Clinical Outpatient Services Priscilla Hernandez, Program Director Crystal Goodwin, Compliance Officer Alvaro Zambrano, Administrator of Newport Oasis Rayjay Peralta, Administrator of Newport Happy Valley and Newport Willow Hill Rebecca Whitehead, Vice President of Residential Services Joe Procopio, CEO of Newport Academy, Board Member 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 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 - HAPPY VALLEYFACILITY NUMBER: VISIT DATE: 12/07/2023

met_with: Crystal Goodwin

complaint_status: SUBSTANTIATED


summary: Complaint Investigation - Substantiated - 1 allegation

raw_content:
Narrative:
Based on confidential interviews and record review of an internal investigation, multiple clients had alleged that one staff member had brought these magazines into the facility. Based on confidential interviews, the allegations made were consistent with each other. Based on record review of incident reports, two inappropriate magazines were brought into the facility by one staff member. One client involved had declined to interview with LPA, but had made multiple documented statements to facility staff. Based on the consistency of allegations made in confidential interviews, LPA observation, and record review, the allegation that staff had provided minor with an inappropriate magazine 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 for Health and Safety Code 1568.092(a)(2). The facility was previously cited for this code on 12/7/2023, based on this LPA assessed a $250 immediate civil penalty for repeat violations on an LIC421FC. LPA delivered appeal rights and conducted an exit interview with Patrick Protacio, Counselor at 12:30pm whose signature confirms the receipt of this document.

Investigation Findings:
13On 5/3/2024 at 12:15pm, 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 allegation. LPA met with Patrick Protacio, Counselor. During the course of the investigation, LPA conducted nine confidential interviews. LPA reviewed the staff schedule, daily notes, staff member training, clients' treatment plans, pertinent incident reports, contraband found inside the facility, and therapist notes. LPA observed that a magazine with adult content including lewd depictions of intercourse was retrieved from a client in care. According to record review and confidential interview, parts of another adult magazine with similar content was found in the facility. These parts of the magazine were disposed of before LPA reviewed. 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 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 - HAPPY VALLEYFACILITY NUMBER: 015650119

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

met_with: Patrick Protacio


summary: Complaint Investigation - Unsubstantiated

raw_content:
Narrative:
Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the allegation occurred. Therefore, the allegation is UNSUBSTANTIATED. A technical violation was issued during the inspection. A copy of this report was given to Douglas Mucheke, Residential Supervisor.

Investigation Findings:
13On 05/06/25 at 9:55AM, Licensing Program Analysts (LPAs) Mona Lam and Jonathan Medina conducted an unannounced inspection at the above listed facility with Douglas Mucheke, Residential Supervisor, who helped with the inspection. The purpose of the inspection was to deliver the complaint findings. At the time of the inspection, there were four clients on the property and two clients were sent to higher levels of care. The complaint alleged that staff do not properly maintain the facility. LPA Mona Lam and LPA Hanako Primer conducted confidential interviews and conducted physical plant inspection, in which inconsistent information was provided. At the beginning of today's inspection, LPAs Lam and Medina observed a doorbell which was not working. Staff informed LPAs that doorbell has not been working for over a week and submitted a ticket for repair. LPAs issued a technical violation under 80087(a) Buildings and Grounds. UnsubstantiatedEstimated 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 - HAPPY VALLEYFACILITY NUMBER: VISIT DATE: 05/06/2025

met_with: Douglas Mucheke, Residential Supervisor


raw_content:
Investigation Findings:
13On 05/21/25 at 10: AM, Licensing Program Analysts (LPAs) Mona Lam and Hanako Primer conducted an unannounced inspection at the above listed facility with Patrick Partachio, Counselor who helped with the inspection. The purpose of the inspection was to deliver the complaint findings. At the time of the inspection, there were five clients on the property. The complaint alleged that staff conducts unreasonable searches. LPA Mona Lam and LPA Hanako Primer conducted confidential interviews. Based on the confidential interviews, a search was warranted due to a phone charger went missing from a classroom at the time of the incident. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the allegation occurred. Therefore, the allegation is UNSUBSTANTIATED. A copy of this report was given to Patrick Partachio, Counselor. UnsubstantiatedEstimated 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 1

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

met_with: Patrick Partachio, Counselor


raw_content:
Investigation Findings:
13On 07/08/2025 at 9: AM, Licensing Program Analyst (LPA) Mona Lam conducted an unannounced inspection at the above listed facility with Kimeeco Epps, Residential Manger who helped with the inspection. The purpose of the inspection was to deliver the complaint findings. At the time of the inspection, there were five clients on the property. The complaint alleged that staff are not preventing inappropriate interaction between minor's in care. LPA Mona Lam and LPA Hanako Primer conducted confidential interviews. Based on the confidential interviews, interviews had discrepancies regarding whether an incident had occurred or not due to not having any staff witnesses. In addition, some clients involved with alleged incidents were not available to interview. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the allegation occurred. Therefore, the allegation is UNSUBSTANTIATED. A copy of this report was given to Kimeeco Epps, Residential Manger. UnsubstantiatedEstimated 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 1

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

met_with: Kimeeco Epps, Residential Manger


raw_content:
Investigation Findings:
13On 07/08/2025 at 9: AM, Licensing Program Analyst (LPA) Mona Lam conducted an unannounced inspection at the above listed facility with Kimeeco Epps, Residential Manger who helped with the inspection. The purpose of the inspection was to deliver the complaint findings. At the time of the inspection, there were five clients on the property. The complaint alleged that staff did not supervise minors. LPA Mona Lam and LPA Hanako Primer conducted confidential interviews and reviewed incident reports. Based on the record review, several incidents occurred of youth leaving the facility, however staff followed protocol in searching for youth and/or called law enforcement. In addition, staff scheduling indicated there was at least one staff scheduled per shift. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the allegation occurred. Therefore, the allegation is UNSUBSTANTIATED. A copy of this report was given to Kimeeco Epps, Residential Manger. UnsubstantiatedEstimated 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 1

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


summary: Complaint Investigation - Substantiated

raw_content:
Narrative:
Based on new evidence, there is a preponderance of evidence to prove that the allegation occurred. Therefore, the allegation is SUBSTANTIATED. A Type B deficiency was issued under 84072(d)(18) Personal Rights. An exit interview was conducted and a copy of this report and appeals rights page were given to Carlos Alvarado, Residential Supervisor prior to exiting the facility.

Investigation Findings:
13On 07/22/2025 at 12: PM, Licensing Program Analyst (LPAs) Mona Lam and Hanako Primer conducted an unannounced inspection at the above listed facility with Carlos Alvarado, Residential Supervisor who helped with the inspection. The purpose of the inspection was to redeliver the complaint findings. The complaint alleged that staff did not treat minor with respect and dignity. Based on four additional confidential interviews, interviews had indicated S19 yelled at minors. Several interviews indicated several staff on site allegedly cussing and/or yelling. One interview indicated S16 using profanity around the proximity of minors in care. In addition, S16 admitted to swearing. 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 - HAPPY VALLEYFACILITY NUMBER: VISIT DATE: 07/22/2025

met_with: Carlos Alvarado, Residential Supervisor


raw_content:
Narrative:
Based on the evidence, there is a preponderance of evidence to prove that the allegation occurred. Therefore, the allegation is SUBSTANTIATED. A technical violation was issued under 84087(c) Building and Grounds. No deficiencies were cited at this time. An exit interview was conducted and a copy of this report was given to Carlos Alvarado, Residential Supervisor prior to exiting the facility.

Investigation Findings:
13On 07/22/2025 at 12: PM, Licensing Program Analyst (LPAs) Mona Lam and Hanako Primer conducted an unannounced inspection at the above listed facility wit hCarlos Alvarado, Residential Supervisor who helped with the inspection. The purpose of the inspection was to deliver the complaint findings. The complaint alleged that staff smoked at the facility. Based on physical plant observation, LPA Lam did not observe any cigarette butts on the premises or on the exterior of the premises. LPA Mona Lam and LPA Hanako Primer conducted confidential interviews. Based on the confidential interviews, two interviews indicated S1 smoking on the the facility grounds and S4 smoking outside the facility grounds. Interviews indicated S1 smoked in their vehicle, however, was corrected to smoke outside the premises. Interviews indicated no staff smoked around the clients. 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 - HAPPY VALLEYFACILITY NUMBER: VISIT DATE: 07/22/2025

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


raw_content:
Narrative:
Based on LPA's interviews, observations, and record review, although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove the alleged violation did or did not occur. Therefore, the allegation is unsubstantiated. No deficiencies were cited at this time. An exit interview was conducted, appeal rights discussed and a copy of this report was left with Carlos Alvarado, Residential Supervisor whose signature on this form confirms receipt.

Investigation Findings:
UnsubstantiatedEstimated Days of Completion: Estimated Days of Completion: Estimated Days of Completion:

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

met_with: Carlos Alvarado - Residential Supervisor


raw_content:
Narrative:
This is a violation of the Health and Safety Code 1568.092(a)(2) Officers, directors and employees of licensed facility; prohibited persons; removal; appeal. The agency is being issued a Type A citation on the attached page LIC 9099-D. An exit interview was conducted, appeal rights discussed and a copy of this report was left with Carlos Alvarado, Residential Supervisor whose signature on this form confirms receipt.

Investigation Findings:
SubstantiatedEstimated Days of Completion: Estimated Days of Completion: Estimated Days of Completion:

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


summary: Facility Evaluation

raw_content:
Narrative:
At 11:01AM, Licensing Program Analyst (LPA) Madi Fremont traveled to the home above for the purpose of conducting an unannounced Required Annual Inspection. LPA met with Administrator Princess Garcia, who helped facilitate this inspection. Currently in care are 6 ambulatory clients. Due to inclement weather and increasingly unsafe driving conditions in the East Bay Area (overturned semi-truck on I680 - Southbound toward San Jose; multiple smaller accidents attributed to rain and wind) LPA and the Administrator agreed to continue the required annual inspection on 12/14 and 12/15 if needed. During this visit, LPA Fremont inspected all postings in the facility, and explained the new annual inspection process to the Administrator. On 12/16/2021 at 10:34AM, LPA Fremont returned to Newport Academy Happy Valley to conclude the facility's required annual inspection. To start the inspection, LPA Fremont introduced Admin. Garcia to the new Community Care Licensing (CCL) Annual Inspection Tool. LPA Fremont left the facility at 10:40AM, to allow the facility to discharge 2 clients from treatment. On 12/20/2021, LPA Fremont returned to the home at 9:30AM to complete the home's annual inspection. During this inspection, LPA Fremont inspected the home's physical plant, reviewed facility records, and conducted interviews with 4 clients and 2 staff. (Continued on Lic809-c) LPA toured the facility inside and out. The facility is a 2 story home, with 3 double client bedrooms and 6 total bathrooms. There are also 6 staff and therapy offices - 3 on the main level of the home and 3 in the downstairs den. Each bedroom was observed to be clean, well furnished, and had adequate lighting and storage. There is one staff bathroom downstairs in the den. Each bathroom was stocked with paper towels and soap for handwashing, hand sanitizer, and COVID-19 handwashing protocol signs. Also in the den is a group therapy room. Fire extinguishers, smoke detectors, and carbon monoxide detectors were observed throughout the facility and were operable. Just inside the front door, LPA observed a check-in station equipped with a sign-in sheet for all staff and essential visitors, temperature log, infrared thermometer, hand sanitizer, and extra Personal Protective Equipment (PPE). In the kitchen, the weekly menu and refrigerator/freezer temperature log were prominently posted. LPA observed at least 2 days of perishable food and 7 days of nonperishable food. Chemicals are kept in a locked storage cage inside a locked door. The backyard had a large lawn and 3 sitting areas with tables and chairs. LPA observed a detached school room down the driveway, which had two rooms with three desks each for clients to do their school work. There was also an extra bathroom and a ping pong table in the school room. All faucets accessible by clients were observed to be between 115 and 119 degrees Fahrenheit. The Administrator was advised to regularly check the water temperature so as not to exceed 120 degrees Fahrenheit. The thermostat wass et to 72 degrees. LPA Fremont inspected 10 staff files. Of the 10 staff files reviewed, 2 staff were missing their LIC Personnel Record, 4 staff were missing their LIC Health Screening, 4 staff were missing their LIC Employee Rights, 2 staff were missing their current 1st aid and medical training verification, and 2 staff were missing their tuberculosis test. Administrator explained that the facility has been working on converting all files to electronic form, and that some documents may have been misplaced or were in the process of being submitted. LPA Fremont issued LIC9102 - Advisory Notes (Technical Advisory) for sections 80066(a)(10), 80066(a)(11), 80066(a)(12)(A), and 80075(f) pertaining to these missing documents. Please reference four LIC Advisory Notes dated 12/13/2021 for details. During tis visit, LPA Fremont was informed that one of the new clients had just tested positive for COVID-19, and LPA left the facility. LPA requested that the client files be submitted over email to be inspected remotely. LPA inspected these files on 01/07/2022, and concluded the inspection remotely. At this time, no deficiencies were observed or cited. The home was issued four LIC Advisory Notes. An exit interview was conducted, Appeal Rights discussed, and a copy of this report was emailed to Administrator Princess Garcia to be signed and returned for the facility file.

report_type: Facility Evaluation

visit_type: Annual

met_with: Administrator Princess Garcia


summary: Facility Evaluation

raw_content:
Narrative:
On 12/13/2021 at 11:09AM, Licensing Program Analyst (LPA) Madi Fremont traveled to the home above for the purpose of conducting an unannounced Case Management - Incident Inspection. LPA met with Administrator Princess Garcia, who helped facilitate this inspection. Currently in care are 6 ambulatory clients. (See LIC811 - Confidential Names dated 12/13/2021) Due to inclement weather and increasingly unsafe driving conditions in the East Bay Area (overturned semi-truck on I680 - Southbound toward San Jose; multiple smaller accidents attributed to rain and wind) LPA and the Administrator agreed to continue the case management inspection on 12/16). During this visit, LPA Fremont notified the Administrator of the incident which required additional follow-up (occurred 10/30/2021), and requested the following documentation to be submitted over email: 1. Needs and Services Plans for C1 and C2 2. Copy of the incident report dated 10/30/2021 3. Staff shift report for 10/30/2021 4. Policy/Procedure for Medical Attention/Emergencies **All documents were received on 12/15/2021** On 12/16/2021 at 10:03AM, LPA Fremont returned to conclude this Case Management Inspection. During this inspection, LPA Fremont conducted an interview with Administrator Princess Garcia. LPA also requested a copy of the most current client roster. Because the staff member who was present during this incident was not on duty at the time of this inspection, LPA Fremont will be conducting a phone interview at a later time. At this time, no deficiencies were observed or cited. An exit interview was conducted, Appeal Rights discussed, and a copy of this report was emailed to Administrator Princess Garcia, whose signature on this form confirms receipt.

visit_type: Case Management


summary: Facility Evaluation

raw_content:
Narrative:
Licensing Program Analyst (LPA) Shikya Belfield made an unannounced case management inspection to the above facility on 2/24/2023 at 9: AM. LPA Belfield met with staff Arlene Tinoco, who assisted with the inspection. The purpose for this inspection is to discuss the information regarding an incident report received by the department. According to the report C1 (see LIC 811 dated 2/24/2023) stated that they were assaulted by staff S1. (see LIC 811 dated 2/24/2023). LPA spoke with compliance coordinator Crystal Goodwin and Denis Chan and requested the following documents; staff schedules, staff contacts, client rosters, activities schedule, needs and service plans, and staff files. Due to information being electronic and not available at this time, and other staff who need to be contacted, more information is needed to conclude this case management. This inspection will be completed at a later date. An exit interview was conducted a copy of this report will be sent to staff Supervisor Precilla Hernandez.

met_with: Arlene Tinoco


summary: Facility Evaluation

raw_content:
Narrative:
On 12/18/2023 at 12:05PM, Licensing Program Analyst (LPA) Selena Hood conducted an unannounced visit to the licensed facility. The purpose of this visit was to conduct the required annual inspection. LPA met with Patrick Protacio, Counselor. At 12:56PM, LPA met with Priscilla Hernandez, Program Director who assisted with obtaining documents. LPA reviewed client files for six clients, including treatment plans, clinician notes, medication orders, and consent agreements. LPA requested copies for the employee files for six employees. LPA conducted two confidential interviews. No deficiencies were cited at this time. The facility requires further review to complete the annual inspection, LPA will return to the facility. LPA conducted an exit interview with Priscilla Hernandez, Program Director at 3:32PM whose signature confirms the receipt of this document.


summary: Facility Evaluation

raw_content:
Narrative:
On 12/21/2023 at 10:35AM, Licensing Program Analyst (LPA) Selena Hood conducted an unannounced visit to the licensed facility. The purpose of this visit was to continue the required annual inspection. LPA met with Sara Koerlin, Residential Supervisor. At the time of the inspection, there were two direct care staff and six clients present in the facility. LPA reviewed the client files for immunization records, admission agreements, and medication logs. LPA reviewed six client files. At 11:55AM, LPA met with Valeria Sanabia, HR Generalist, virtually to review the staff training files. During the employee file review, LPA observed that one staff member had an expired CPR certification. LPA delivered a Technical Violation for California Code of Regulations 80075(f) due to this deficiency. At 1:18PM, LPA observed the locked centrally stored medication room. LPA observed that the medications were kept in a locked cabinet and the files were present. During the review of the online medication system and the centrally stored medication log, LPA observed that the psychotropic medications are not kept on a separate log and the medication log does not have the number of refills or quantity of medications. LPA delivered a Technical Advisory for California Code of Regulations 84070(b)(13). The facility is currently pending a referral to the Technical Support Program regarding the medication administration records LPA conducted one confidential interview. LPA reviewed the emergency plan binder. Further review is necessary in order to finish the required annual inspection, LPA will return. LPA conducted an exit interview with Sara Koerlin, Residential Supervisor at 1:46PM whose signature confirms the receipt of this document.

met_with: Sara Koerlin


summary: Facility Evaluation

raw_content:
Narrative:
On 10:40AM, Licensing Program Analyst (LPA) Selena Hood conducted an unannounced visit to the licensed agency. The purpose of this visit was to finish conducting the required annual inspection for this facility. LPA met with Patrick Protacio, Counselor. At the time of the visit there were six clients present. There were two direct care staff, one counselor, two therapists, one teacher, and the discharge coordinator present in the home. LPA conducted one confidential interviews. Four clients had declined to interview, one client had a fever and was resting in their room. LPA conducted a physical site inspection of the facility. The facility has four residential bedrooms and three client bathrooms. LPA observed the bedrooms to have clean, fresh linens and the bathrooms to have soap and paper towels. LPA observed the facility to have a sufficient amount of perishable and non-perishable items, LPA observed the posted weekly menu. LPA observed the locked medication room which had medications locked in another cabinet. No deficiencies were cited at this time. LPA conducted an exit interview with Rayjay Peralta, Residential Supervisor, at 12:17PM whose signature confirms the receipt of this document.


summary: Facility Evaluation

raw_content:
Narrative:
On 1/8/2024 at 11:00AM, Licensing Program Analyst (LPA) Selena Hood and LPA Paul Simien conducted an unannounced visit to the facility in order to assess an Enhanced Civil Penalty (ECP) regarding a substantiated incident. LPAs met with Patrick Protacio, Counselor. LPAs met with Rayjay Peralta, Residential Supervisor/Administrator at 11:15AM. On 12/7/2023, the department concluded an investigation into the allegations that facility staff member had sexually abused a minor while in care. The allegations were found to be substantiated and the facility was cited per Health and Safety Code 1568.092(a)(2). The department has concluded an analysis and has determined that an Enhanced Civil Penalty is warranted for the serious bodily injury. Pursuant to the Enhanced Civil Penalty law, Health and Safety (H&S) code section 1548(f)(1)(c), the Department will be issuing an immediate civil penalty of $2,500.00 on today's date, 1/8/2024. LPA delivered the immediate exclusion letter for one staff member to Rayjay Peralta, Residential Supervisor/Administrator. A copy of this report, the LIC811-Confidential Names List, Civil Penalty Assessment, and Appeal Rights were delivered to Rayjay Peralta, Residential Supervisor/Administrator at 11:23AM whose signature confirms the receipt of this document.

met_with: Rayjay Peralta


summary: Facility Evaluation

raw_content:
Narrative:
On 3/21/2024 at 12:40pm, Licensing Program Analyst (LPA) Selena Hood conducted an unannounced visit to the licensed facility. The purpose of this visit was to conduct a case management visit following the Non-Compliance Conference conducted on 12/7/2023. LPA met with Sara Koerlin, Residential Supervisor. LPA conducted a walk through of the facility. LPA did not observe physical plant deficiencies. LPA observed that the facility had moved kitchen operations to the outside area that used to be utilized as a school building. LPA observed that the evacuation plans and facility sketches on site were up to date with this change. LPA requested the staff schedule, the facility board minutes, and the client files. LPA received the board minutes via email. LPA reviewed the staff schedule and saw that the Administrator was not included on the staff schedule. LPA requested that the facility send the times that the Administrator's has been on site for the week of 3/18/2024 to 3/24/2024 by end of day on 3/27/2024. LPA reviewed the treatment plans, admission agreements, and acknowledged house rules for six clients. LPA found that the six clients had these plans in their digital files including client and authorized representative signatures. LPA conducted three confidential interviews. No deficiencies were cited during this visit. LPA conducted an exit interview with Sara Koerlin, Residential Supervisor at 2:12pm whose signature confirms the receipt of this document.


summary: Facility Evaluation

raw_content:
Narrative:
On 7/18/2024 at 12:32pm, Licensing Program Analyst (LPA) Selena Hood conducted an unannounced visit to the licensed facility. The purpose of this visit was to conduct client interviews for the quarterly Non-Compliance visit that was previously began on 6/12/2024. LPAs met with Sara Koerlin, Residential Supervisor. The facility had a census of five clients. LPA conducted four interviews, one youth was sleeping at the time of the visit. LPA conducted an exit interview with Sara Koerlin, Residential Supervisor, at 12:53pm whose signature confirms the receipt of this document.


summary: Facility Evaluation

raw_content:
Narrative:
On 04/08/25 at 10: AM, Licensing Program Analysts (LPAs) Mona Lam and Hanako Primer conducted an unannounced inspection to the licensed facility listed above. The purpose of the inspection is to conduct a quarterly non-compliance conference (NCC) audit. LPAs met with Douglas Mucheke, Residential Supervisor. There are three clients on site at this time at the beginning of the visit. Three clients were out on therapy at the beginning of the visit. LPAs inspected LIC 500, staff schedule, board of directors' meeting minutes, and five staff files. At the time of the inspection, LPAs observed one staff has missing training documentation on emotional development, sexuality development, and health development. One staff has missing documentation on house rules. LPAs issued a technical violation: 84065(i)(5) Personnel Requirements. LPAs were unable to observe training plans that encompasses 84065(h)(4)(A) to (E) Personnel Requirements. LPAs issued a technical violation: 84065(h)(4) Personnel Requirements. LPAs conducted six (6) client interviews. At this time of the inspection, LPAs were unable to observed client files and incident reports. LPAs will return to the facility at a later date to complete the inspection. LPAs conducted an exit interview with Douglas Mucheke at 3: PM. Douglas Mucheke's signature confirms the receipt of this document.


summary: Facility Evaluation

raw_content:
Narrative:
On 04/22/25 at 1: PM, Licensing Program Analysts (LPAs) Mona Lam and Hanako Primer conducted an unannounced inspection to the licensed facility listed above. The purpose of the inspection is to continue a quarterly non-compliance conference (NCC) audit. LPAs met with Douglas Mucheke, Residential Supervisor and Alvaro Zambrano, Program Manager. There are six clients on the site at the time of the inspection. According to client interviews and review of staff schedule, LPAs found that staff was not in ratio multiple times. A technical violation was issued to the licensee under 80022(k) Plan of Operation. Based on staff and client interviews, it was reported that administrator is not on site consistently to meet the hours agreed upon on the NCC's terms. A technical assistance was issued to licensee under 84064(c) Administrator Qualifications and Duties. LPAs conducted an exit interview with Alvaro Zambrano. Alvaro Zambrano's signature confirms the receipt of this document.

met_with: Alvaro Zambrano - Program Manager


summary: Facility Evaluation

raw_content:
Narrative:
On July 2nd, 2025 at 9:55AM, Licensing Program Analysts (LPAs) Hanako Primer and Simran Nayyar conducted an unannounced inspection to the licensed facility listed above. The purpose of the inspection is to conduct a quarterly non-compliance conference (NCC) audit. LPAs met with Carlos Alvarado, Residential Supervisor, Fausto Aramburo, Compliance Specialist, and Kimeeco Epps, Residential Manager. There were five clients on site at this time at the beginning of the inspection. One new client arrived during the inspection. LPAs inspected LIC 500, staff schedule for June, board of directors' meeting minutes, and five staff files. At the time of the inspection, LPAs observed trainings on individualized care, client supervision, emotional development, sexuality development, health development, personal rights, personnel requirements, reporting requirements, and house rules in five out of five staff files. LPAs inspected five client files, and observed client health/safety, house rules, education on abuse reporting, and personal rights in four out of five client files. One client did not have signed forms in their client file. Staff corrected this during the inspection and the client signed all required intake forms. LPAs conducted three (3) client interviews and a walkthrough of the facility. LPAs observed two open holes in the wall of C1 and C3's shared bedroom. Two holes were temporarily patched. LPAs observed three holes in the walls of the downstairs recreation room. LPAs observed the work orders to repair the holes. Residential Supervisor stated that an administrator appointment was currently pending for this facility, and the new candidate is training for the role. LPAs conducted an exit interview with Fausto Aramburo, Compliance Specialist, Kimeeco Epps, Residential Manager. Carlos Alvarado, Residential Supervisor's signature confirms the receipt of this document. A copy of this report was left with Carlos Alvarado.


summary: Facility Evaluation

raw_content:
Narrative:
On 07/22/2025 at 12: PM, Licensing Program Analyst (LPAs) Mona Lam and Hanako Primer conducted an unannounced inspection at the above listed facility with Carlos Alvarado, Residential Supervisor who helped with the inspection. The purpose of the inspection was conduct a case management. Based on several interviews, it was indicated one shift was conducted out of staff to client ratio. Based on the plan of operation, the shift indicated in having 1:5 staff to client ratio specifically for that shift. In addition, several interviews stated there was one staff on the property during the time of having six clients on the property. A technical violation was issued under 80022(k) Plan of Operation. No deficiencies were cited at this time. An exit interview was conducted and a copy of this report was given to Carlos Alvarado, Residential Supervisor prior to exiting the facility.


summary: Facility Evaluation

raw_content:
Narrative:
On August 19th, 2025, Licensing Program Analyst (LPA) Hanako Primer conducted an inspection at the above licensed facility to follow up on an incident report received on August 14th, 2025. LPA met with Carlos Alvarado, Residential Supervisor, and informed them of the purpose of the visit. At the time of the visit, there were five clients at the facility. LPA conducted one confidential interview. LPA observed chat records that the client involved was put on a one-on-one supervision plan, and parent messages regarding the incident. No deficiencies were cited at this time. An exit interview was conducted, appeal rights discussed and a copy of this report was left with Carlos Alvarado, Residential Supervisor whose signature on this form confirms receipt.


summary: Facility Evaluation

raw_content:
Narrative:
On October 2nd, 2025 at 10:25AM, Licensing Program Analyst (LPA) Hanako Primer conducted an unannounced inspection to the licensed facility listed above. The purpose of the inspection is to conduct a quarterly non-compliance conference (NCC) audit. LPAs met with Carlos Alvarado, Residential Supervisor. There were five clients on site at this time. LPA inspected LIC 500, staff schedule for September, board of directors' meeting minutes, and five staff files. At the time of the inspection, LPA observed trainings on individualized care, client supervision, emotional development, sexuality development, health development, personal rights, personnel requirements, reporting requirements, and house rules in five out of five staff files. LPA inspected five client files, and observed client health/safety, house rules, education on abuse reporting, and personal rights in five out of five client files. LPA conducted four client interviews and a walkthrough of the facility. No deficiencies were cited at this time. LPA conducted an exit interview with Carlos Alvarado, Residential Supervisor, whose signature confirms the receipt of this document. A copy of this report was left with Carlos Alvarado.


summary: Facility Evaluation

raw_content:
Narrative:
On November 17th, 2025 at 10:30AM, Licensing Program Analysts (LPAs) Hanako Primer and Amee Li conducted an unannounced Annual Inspection at listed facility. LPAs met with Carlos Alvarado, Residential Supervisor, and toured the facility inside and out. The Group Home is licensed to serve six clients. Present during the inspection were five clients. LPAs inspected five staff files. LPAs observed staff training records, personnel records, health screenings, CPR certificates, CPI trainings, and drivers licenses. LPAs toured the facility. LPAs observed three bedrooms and four bathrooms. LPA observed facility license, personal rights, facility sketch, meal menu, grievance procedure, and activity schedule posted on the walls throughout the facility. LPA tested the water temperature and found it to be 108 degrees which is in range. Sharps were locked and chemicals were safely stored. There were two days of perishable foods and seven days non-perishable foods present. The medication was also stored and locked in nurses room. The facility is in good repair and clean. LPAs observed two trash bins in the kitchen without lids. LPAs issued one technical violation under California Code of Regulations (CCR) 80088(f)(1) Fixtures, Furniture, Equipment, and Supplies. See attached LIC9102. LPAs inspected centrally stored medication. LPAs observed one medication for C1 (M1) and one medication for C2 (M2) was missing the prescription number and name of the issuing pharmacy. LPA issued one Type B deficiency under CCR 80075(k)(7)(E) Health-Related Services. See attached 809-D form. LPAs toured the backyard. There were no open bodies of water. The backyard was in good repair and clean. LPA interviewed two staff and two clients. An exit interview was conducted, appeal rights discussed, and a copy of this report was given to Carlos Alvarado, Residential Supervisor.


summary: Facility Evaluation

raw_content:
Narrative:
On November 18th, 2025 at 10:15AM, Licensing Program Analysts (LPAs) Hanako Primer and Amee Li conducted a unannounced Annual Continuation Inspection at listed facility. LPAs met with Carlos Alvarado, Residential Supervisor. The Group Home is licensed to serve six clients. Present during the inspection were five clients. LPAs reviewed five client files and disaster preparedness plan. LPAs inspected needs and services plans, medication administration records, client rights, grievance procedures, disaster drills, and program policies. LPAs found that one out of five client files did not contain bedroom sharing agreements. Board of Directors meeting minutes were not readily available for LPAs to review. At this time there were no deficiencies. Based on observation and record review, LPAs issued two technical violations under California Code of Regulations (CCR) 84087(e) Buildings and Grounds and CCR 84063(a)(10) Accountability. See attached LIC9102 forms. An exit interview was conducted and a copy of this report was given to Carlos Alvarado, Residential Supervisor.


summary: Facility Evaluation

raw_content:
Narrative:
On November 20th, 2025 at 9:00AM, Licensing Program Analyst (LPA) Hanako Primer and Licensing Program Manager (LPM) Joel Segura conducted a Microsoft Teams Meeting with Crystal Butler, Compliance Manager, Misty England, Head of Operations, Mark Pellegrino, Chief Compliance Officer, Joe Vaccaro, Vice President of Residential Operations, and Kristina Schemnitzer, Executive Director . LPA and LPM notified facility management that the facility's case will be forwarded for legal review due to compliance issues in the prior two years of inspections. Multiple citations relating to the non-compliance plan terms were issued during the period of the non-compliance plan. During the meeting, attendees discussed ownership structure of Newport Academy's licensee, Monroe Operations LLC. LPA Primer conducted an exit interview with Crystal Butler, Compliance Manager. This document is sent for virtual signature.

met_with: Crystal Butler - Compliance Manager


summary: Facility Evaluation

raw_content:
Narrative:
On 04/15/25 at 10: AM, Licensing Program Analysts (LPAs) Mona Lam and Hanako Primer conducted an unannounced inspection to the licensed facility listed above. The purpose of the inspection is to conduct a continuation quarterly non-compliance conference (NCC) audit. LPAs met with Douglas Mucheke, Residential Supervisor. There are six clients on the site at the time of the inspection. LPAs inspected five client files, regarding on health and safety, house rules, education on reporting sexual and physical abuse, and personal rights documentation. These documents are in compliance. LPAs inspected incident reports. LPAs observed multiple incidents that have not been reported to the department between March 2025 to April 2025. LPAs issued a Type B deficiency under 80061(b) Reporting Requirements. LPAs conducted four staff interviews. LPAs conducted a physical plant inspection. LPAs observed no deficiencies at this time. LPAs conducted an exit interview with Douglas Mucheke. Douglas Mucheke's signature confirms the receipt of this document. LPAs also reviewed appeals rights prior to leaving the facility.


summary: Facility Evaluation

raw_content:
Narrative:
On May 21, 2025 at 10:22AM Licensing Program Analysts (LPAs) Hanako Primer and Mona Lam conducted an unannounced case management - incident inspection at the above licensed facility to follow up on previously submitted incident reports (IRs). One IR was submitted on 05/19/2025 and another was submitted on 05/13/2025. LPAs met with Gianna Rosario (S1), Care Coordinator and Patrick Protacio, Counselor and explained the purpose of the visit. At the time of the inspection, there were 5 clients at the facility. LPAs conducted one confidential client interview. One client declined interview. LPAs reviewed psychotropic medication administration records. Based on record review LPAs determined one medication was missed on 05/07/2025. LPAs issued one Type B Violation under California Code of Regulations 80075(b)(5)(B) Health Related Services. See attached 809-D form. S1 stated that Administrator was on paid time off, and the residential supervisor was no longer with the facility. Patrick Protacio, Counselor, is the substitute. Community Care Licensing (CCL) received an incident report from an incident which occurred on 05/07/2025 on 05/19/2025. This was after the 7-day period given to a facility to submit a written incident report. LPAs issued one Technical Violation under California Code of Regulations (CCR) 80061(b) Reporting Requirements. An exit interview was conducted, appeal rights discussed, and a copy of this report were provided to Patrick Protacio - Counselor.

met_with: Patrick Protacio - Counselor


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
On July 2nd, 2025 at 9:55AM Licensing Program Analysts (LPAs) Hanako Primer and Simran Nayyar conducted an unannounced case management - incident inspection at the above licensed facility to follow up on two incident reports (IRs) submitted on 06/24/2025. LPAs met with Carlos Alvarado, Residential Supervisor, and explained the purpose of the visit. There were five clients on site at this time at the beginning of the inspection. One new client arrived during the inspection. LPAs conducted three confidential client interviews and one confidential staff interview. LPAs conducted a walkthrough of the facility. LPAs reviewed medication administration records. Based on record review and interview, LPAs determined a staff member administered the incorrect dosage of medication to a client. LPAs also determined that a staff member administered medication to a client without an order. LPAs issued one Type B Violation under California Code of Regulations 80075(b) Health Related Services. See attached 809-D form. An exit interview was conducted, appeal rights discussed, and a copy of this report along with appeal of rights was provided to Carlos Alvarado, Residential Supervisor.

Deficiencies:
80075(b): Clients shall be assisted as needed with self-administration of prescription or nonprescription medications.

title:
1
2
3
4
5
6
780075(b) Health Related Services


summary: Facility Evaluation

raw_content:
Narrative:
On October 23rd, 2025 at 11:00AM, Licensing Program Analyst (LPA) Hanako Primer conducted a case management inspection at the above licensed facility. LPA met with Carlos Alvarado, Residential Supervisor and informed them of the purpose of the visit. At the time of the visit, there were six clients at the facility. Upon inspection of one (1) former staff member's personnel file, LPA found that the facility did not maintain record of the staff member's bachelor's degree. The staff member's resume states that a bachelor's degree was obtained in December 2022. Staff was hired in 2021 as a Care Coordinator, which did not require a degree but was promoted to counselor (which requires a degree according to facility program statement) in January 2023. LPA inspected facility physical plant. LPA issued one Type B citation under 80066(a)(6) Personnel Records. An exit interview was conducted, appeal rights discussed, and a copy of this report was left with Carlos Alvarado, Residential Supervisor, whose signature on this form confirms receipt.


summary: Facility Evaluation

raw_content:
Narrative:
On 6/12/2024 at 12:35pm, Licensing Program Analyst (LPA) Selena Hood conducted a visit to the licensed facility. The purpose of this visit was to conduct a case management visit following the Non-Compliance Conference conducted on 12/7/2023. LPA met with Sara Koerlin, Residential Supervisor. LPA conducted a walk through of the facility. LPA did not observe physical plant deficiencies. There were no clients present at the home during the inspection; the clients were on a scheduled outing. LPA requested the staff schedule, staff training, facility board minutes, and client files. LPA received the board minutes via email. LPA observed that the facility had conducted additional training on boundaries on April 24, 2024. LPA received the training topics via email. LPA reviewed the treatment plans, admission agreements, and acknowledged house rules for four clients. LPA found that the two clients were missing authorized representative signatures on their treatment plans. This poses a potential risk to the health, safety, and or personal rights of clients in care. LPA delivered a Type B citation for Title California Code of Regulations 84070(c)(1) Children's Records. LPA will return to conduct client interviews. LPA conducted an exit interview with Sara Koerlin, Residential Supervisor at 1:48pm whose signature confirms the receipt of this document.


summary: Facility Evaluation

raw_content:
Narrative:
On 10/09/24 at 10: AM, Licensing Program Analysts (LPAs) Mona Lam and Jonathan Medina conducted an unannounced visit to the licensed facility listed above. The purpose of the visit is to conduct a quarterly non-compliance conference (NCC). LPAs met with Levi Banks, Residential Supervisor. There are five clients on site at this time with three staff members at the beginning of the visit. Levi informed LPAs that RayJay Peralta left Newport Academy on August 3, 2024. Community Care Licensing did not receive notification within 10 days of a certified administrator taking place after the departure of the former administrator. Based on the non-compliance conference plan, the facility agreed to ensure that the designated administrator at each site is consistent with the administrator on file. The administrator will be working at the facility a minimum of 20 hours a week. This poses an immediate risk to the health, safety, and or personal rights of clients in care. LPA Lam delivered a Type A citation for Title California Code of Regulations 84064(b) Administrator Qualifications and Duties (Refer to LIC 809-D). LPAs are informed that Kim Claspell-Ochoa is on the pending list for administrator certification since September 4, 2024. In addition, Kim is the potential administrator for Newport Happy Valley. LPAs observed facility board minutes, staff schedule, LIC 500, and five client files. LPAs observed documented signatures of client rights, house rules, education on reporting abuse, and treatment plans. LPAs reviewed five staff files. Based on five staff files, the training documents are in compliance, except one staff member is missing documentation regarding about health development, sexuality development, and emotional development. Newport Happy Valley is currently working in compliance to document all staff training based on the citation given to Newport Arena on 10/02/2024. LPAs conducted five (5) client interviews. LPAs conducted a walk through of the facility. LPAs did not observe physical plant deficiencies. LPAs conducted an exit interview with Levi Banks at 4: PM and delivered one (1) deficiency. In addition, LPAs delivered an appeals rights page. Levi Banks's signature confirms the receipt of this document.

met_with: Levi Banks, Residential Supervisor


summary: Facility Evaluation

raw_content:
Narrative:
On 01/17/25 at 10: AM, Licensing Program Analysts (LPAs) Mona Lam and Hanako Primer conducted an unannounced visit to the licensed facility listed above. The purpose of the visit is to conduct a quarterly non-compliance conference (NCC). LPAs met with Kim Claspell-Ochoa, Residential Supervisor. There are five clients on site at this time at the beginning of the visit. LPAs are informed that Levi Banks is the potential administrator for Newport Happy Valley. Newport Academy currently have supervisors who taken the administrator certification course, however they have not received their administrator certificate yet. LPAs observed facility board minutes, staff schedule, LIC 500, and five client files. LPAs observed documented signatures of client rights, house rules, education on reporting abuse, and treatment plans. LPAs reviewed five staff files. Based on five staff files, the training documents are in compliance, except there were missing documentation regarding about health development, sexuality development, and emotional development. Newport Happy Valley is currently working in compliance to document all staff training based on the citation given to Newport Arena on 10/02/2024. LPAs conducted five (5) interviews. LPAs conducted a walk through of the facility. LPAs did not observe physical plant deficiencies. LPAs conducted an exit interview with Kim Claspell-Ochoa at 5: PM. Kim Claspell-Ochoa's signature confirms the receipt of this document.


raw_content:
Investigation Findings:
UnsubstantiatedEstimated Days of Completion: Estimated Days of Completion: Estimated Days of Completion:

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


facility_name: NEWPORT ACADEMY - HIGHCLIFF

raw_content:
Narrative:
Confidential witness statements revealed that C1's injury was self-inflicted. Confidential interviews revealed that the facility did not report the incident to C1's authorized representatives. Other confidential interviews revealed that the facility did report the incident to C1's authorized representatives. C1 was unable to be interviewed. Documented attempts to interview C1 are in the facility file. Based on confidential interviews, and records reviewed, the allegations that C1 sustained a fracture while in care, and staff did not report incident to C1's responsible party, may have occurred, however are not supported or proven by evidence. Therefore, the allegations are unsubstantiated at this time. Exit interview was conducted and a copy of this report, along with the appeal rights were explained and provided to Director Amanda Seymour.

Investigation Findings:
13On May 10, 2022, at 2:40pm, Licensing Program Analyst (LPA) Adrian Mendez arrived unannounced to the facility and met with Director Amanda Seymour of Newport Academy-Highcliff to discuss the investigative findings for the allegations noted above. LPA conducted an inspection with the facility on October 7, 2021, at 10:31am, no deficiencies were noted. During the investigation, LPA interviewed three Group Home staff (S1, S2, S3), two biological parents (BP1, BP4) of clients #1, and #4 (C1, C4), and three clients (C2, C3, C5). LPA also reviewed one Serious Incident Report (SIR) dated September 19, 2021, and one police report. Client #1 and Client #4 (C1, C4) were unavailable to be interviewed. On September 28, 2021, the Department received allegations that a youth sustained a fracture while in care, and staff did not report incident to youth's responsible party. It was reported that C1 had fractured C1's right hand during an incident that took place on 09/19/2021, at the facility. Confidential witness statements revealed that C1 was observed hitting walls and objects inside the facility. 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 - HIGHCLIFFFACILITY NUMBER: VISIT DATE: 05/10/2022

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

met_with: Amanda Seymour


summary: Facility Evaluation - 1 deficiency

raw_content:
Narrative:
On November 3, 2021, at 10: AM, Licensing Program Analysts (LPA) Jesus Cervantes and Sarah Alvizo made an unannounced annual inspection of the facility. This inspection also serves as a Post Licensing Inspection for the facility. LPAs met with Residential Supervisor, Nathan Castillo. The facility was inspected inside and out with Residential Supervisor, Nathan Castillo. The facility is a two-story residence with three client bedrooms, three staff offices, one recreational room, one classroom, and five bathrooms. The property also has a staff/family therapy office located in the backyard of the facility. The facility provides awake night staff. The facility is operating with the capacity of six clients and there are six clients in care. A physical plant inspection was completed and included the following checks: There are no guns or weapons in the facility as stated by Residential Supervisor, Nathan Castillo. Facility grounds are clean and free of debris. There is adequate indoor and outdoor activity space. Sports equipment/toys/books/games were observed for children's recreation time. All facility smoke detectors and carbon monoxide detectors were tested and observed to be in working order; fire extinguisher is properly charged and serviced. Licensee maintains an adequate supply of perishable and non-perishable foods to prepare the items on the posted menu. All required forms are posted including the Grievance Procedures, Visitation Policies, Personal Rights form, and the Emergency Disaster Plan was posted. Sharp knives were inaccessible and stored in a locked drawer in the kitchen. All hazardous items were not made inaccessible to areas where residents do not have access. Cleansers/chemicals were to be stored in a locked cabinet in the kitchen. At 11: AM, LPA observed two 22 fluid ounce bottles of disinfecting spray in an unlocked kitchen cabinet under the microwave which was accessible to clients. This poses an immediate health, safety, or personal rights risk to the residents in care, the facility will be cited. The facility immediately secured the disinfecting spray and secured them in a locked cabinet. See Page Two Client medications and the first aid kit were locked in the medication room located under the staircase. Medication room has a locking door and a locking medication cabinet and refrigerator within the room. Medication logs are kept electronically. At 11: AM, Residential Supervisor, Nathan Castillo stated that the facility did not have a current edition of a first aid manual approved by the American Red Cross, the American Medical Association or a state or federal health agency. This poses a potential health, safety, or personal rights risk to the residents in care, the facility will be cited. Individual client beds were observed with clean linens, pillows, comforters, and mattresses in good repair. All three bedrooms contain two twin beds. The facility has two full client bathrooms and one-half client bathroom. The water temperature in the half client bathroom was tested at 12: PM and registered at 107.9 degrees Fahrenheit which is within the appropriate range of 105 degrees to 120 degrees Fahrenheit. The property contains a pool in the backyard which is fenced by a five-foot tall fence which does not obscure the pool from view. The pool has an entrance gate that swings away from the pool, it self-closes and has a self-latching locking device located no more than six inches from the top of the gate. The pool was covered by a safety net. Based on this inspection, the facility is not in compliance. The facility is being cited for Title 22, Division Six, Regulation 80087(g), Disinfectants, cleaning solutions, poisons, firearms and other items that could pose a danger if readily available to clients shall be stored where inaccessible to clients. This poses an immediate health, safety, or personal rights risk to the residents in care. The facility is also being cited for Title 22, Division Six, Regulation 80075(g)(1)(A), If the facility has no medical unit on the grounds...A current edition of a first aid manual approved by the American Red Cross, the American Medical Association or a state or federal health agency. Due to time constraints, LPA will return to the facility to conduct a continuation of staff and client file reviews. Exit interview was conducted and a copy of this report, along with Appeal Rights was provided to Residential Supervisor, Nathan Castillo.

Deficiencies:
80087(g): Deficient Practice Statement
1
2
3
4Based on observation, the licensee did not comply with the section cited above when LPA observed two 22 fluid ounce bottles of disinfecting spray in an unlocked kitchen cabinet under the microwave which was accessible to clients. which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 11/04/2021
Plan of Correction
1
2
3
4

met_with: Nathan Castillo

title:
Buildings and Grounds

(g) Disinfectants, cleaning solutions, poisons, firearms and other items that could pose a danger if readily available to clients shall be stored where inaccessible to clients.

This requirement is not met as evidenced by


summary: Facility Evaluation

raw_content:
Narrative:
On November 04, 2021, at 9: AM, Licensing Program Analysts (LPA) Jesus Cervantes and Sarah Alvizo continued the unannounced annual inspection, which was started on November 03, 2021. LPAs met with Residential Supervisor, Nathan Castillo. All the client files are stored and maintained via an electronic database. At 9: AM, LPAs began to review a sample of six of six client files during the time of inspection with Residential Supervisor, Nathan Castillo. All files did not contain the necessary documents per Title Regulations. LPA observed three of six client files did not have immunization records. Per California Code of Regulations, Title 22, Section 84070(b) The following information regarding the child shall be obtained and maintained in the child's record: (5) Dental and medical history, if available, including immunization records; and physician's orders for any medically necessary diet as specified in Section 80076(a)(6). A technical violation will be issued. Due to the need to conduct client/staff interviews, and continue staff file reviews, this inspection will need to be continued at a later date. An exit interview was conducted, and a copy of this report was provided to Residential Supervisor, Nathan Castillo.


summary: Facility Evaluation

raw_content:
Narrative:
On November 5, 2021 at 9:24am, Licensing Program Analyst (LPA) Adrian Mendez arrived unannounced at the facility to conduct an Annual Continuation inspection for the annual that began on 11/03/2021. LPA met with Program Manager Ellen Asquith. All the staff files are stored and secured at a different facility location (#306090011). 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. During the inspection, two clients were interviewed. Four clients declined to be interviewed. Due to the need to complete staff interviews, this inspection will need to be continued at later date. Based on the facility inspection, 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

raw_content:
Narrative:
On November 10, 2021 at 2:22pm, Licensing Program Analyst (LPA) Adrian Mendez arrived unannounced at the facility to conduct an Annual Continuation inspection for the annual that began on 11/03/2021. LPA met with Residential Supervisor Nathan Castillo. During the inspection, four facility staff were interviewed. Due to the need to complete staff interviews, this inspection will need to be continued at a later date. Based on the facility inspection, there are no deficiencies found at this time. An exit interview was conducted, and a copy of this report was explained and provided to Residential Supervisor Nathan Castillo.


summary: Facility Evaluation

raw_content:
Narrative:
On December 8, 2022 at 11:34am, Licensing Program Analyst (LPA) Adrian Mendez arrived unannounced at the facility to conduct a Required Two Year Annual 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 one of the client bathrooms was measured at 114.2 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 living room area. Cleansers/chemicals are locked and stored in locked cabinets in the kitchen. Sharp knives are inaccessible and stored in the 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 and a gate that is five tall and self-latching. Emergency exits were free from obstruction. LPA reviewed five client files during the inspection. All client files had the required documents per Title Regulations. All client files are maintained on a secured internet database. 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. 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.


summary: Facility Evaluation

raw_content:
Narrative:
On December 15, 2022 at 10:14am, Licensing Program Analyst (LPA) Adrian Mendez arrived unannounced at the facility to conduct an Annual Continuation inspection of the Required Two Year Annual inspection that began on 12/08/2022. LPA met with Residential Supervisor Nathan Castillo, Lead Care Coordinator Michael Bautista, and Human Resources Manager Wendy Cabrera. During the inspection, LPA reviewed five staff files. LPA also conducted interviews with two staff and two clients. All the staff records are accessible electronically via a secured records portal. LPA reviewed 5 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. LPA discussed and reviewed the following inspection components; Operational Requirements, Emergency Disaster Preparedness, and the Emergency Intervention Plan. 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 Lead Care Coordinator Michael Bautista. Due to printer malfunction, this report will be emailed to Lead Care Coordinator Michael Bautista, and Residential Supervisor Nathan Castillo.


summary: Facility Evaluation

raw_content:
Narrative:
On July 3, 2024, at 11: AM, Licensing Program Analyst (LPA) Jacqueline Garcia conducted an unannounced inspection at the facility and met with Daniel Brito, Residential Supervisor regarding an incident that occurred on June 27, 2024. The incident involved Staff (S1) restraining a Client (C1), see Confidential Names form (LIC 811) dated July 3, 2024. LPA Garcia conducted interviews with two Clients (C2, C3). LPA reviewed S1 facility file and obtained records for S1. LPA conducted an investigation to see if all proper protocol was taken during the incident to ensure C1's safety while conducting a restraint. Due to further review the investigation is being extended. An exit interview was conducted with Daniel Brito, Residential Supervisor. A copy of this report and LIC 811 were provided to Daniel Brito, Residential Supervisor.

met_with: Daniel Brito-Residential Supervisor


summary: Facility Evaluation

raw_content:
Narrative:
On November 07, 2024 at 09: AM, Licensing Program Analyst (LPA) Jacqueline Garcia arrived unannounced at the facility to conduct a Required Annual inspection of the facility. The facility was inspected inside and out with Administrator Madison Holstein. 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 was measured at 113 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 living room area. Cleansers/chemicals are locked and stored in locked cabinets in the kitchen. Sharp knives are inaccessible and stored in the 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 Administrator, Madison Holstein. 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 and a gate that is five tall and self-latching. Emergency exits were free from obstruction. LPA reviewed five client files 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 files are stored and secured at a different facility location (#306004815). Staff records are also accessible electronically via a secured records portal. LPA reviewed 5 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. . During the inspection, interviews were conducted with two children, and two staff. Based on the facility inspection, confidential interviews, and files reviewed there are no deficiencies found at this time. An exit interview was conducted, and a copy of this report along with LIC 811 was explained and provided to Administrator, Madison Holstein.

met_with: Madison Holstein-Administrator


summary: Facility Evaluation

raw_content:
Narrative:
On July 18, 2024, at 8: AM, Licensing Program Analyst (LPA) Jacqueline Garcia met with Newport Academy-HighCliff, representative, to deliver a case management deficiency report. During the review of an incident that occurred on 06/27/24, information obtained from the Special Incident Report (SIR) that was submitted from the facility to Community Care Licensing (CCL) revealed a concern regarding an incident involving Staff (S1) restraining a Client (C1), see Confidential Names form (LIC 811) dated 7/18/24. LPA conducted an investigation to see if all proper protocol was taken during the incident to ensure C1's safety while conducting a restraint. LPA reviewed the facility staff file and interviewed two clients (C2, C3) during the investigation, LPA was not able to interview C1 per their father's request. Confidential interviews and documents reviewed revealed S1 did not ensure C1's safety during a restraint, by utilizing a one-person restraint placing their arm around C1's neck to redirect C1 to the floor, therefore, this is a violation of General Licensing Requirement (Chapter 1) section 80072 (a)(1). The facility is being cited for violation of General Licensing Requirement (Chapter 1) section 80072 (a)(1) Personal Rights. Except for children's residential facilities, each client shall have personal rights which include, but are not limited to, the following: To be accorded dignity in his/her personal relationships with staff and other persons. A copy of the report was discussed and provided along with appeal rights to Newport Academy-HighCliff, representative.


facility_name: NEWPORT ACADEMY - MORADA

raw_content:
Narrative:
Based on confidential interviews, and records reviewed, the allegation that staff did not prevent C1 and C2 from engaging in sexual contact is unsubstantiated. Meaning, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. An exit interview was conducted and a copy of this report, along with the appeal rights were explained to Residential Supervisor Tiffany Norris. Due to printer malfunction, this report will be emailed to Residential Supervisor Tiffany Norris.

Investigation Findings:
13On February 14, 2023, at 2:14pm, Licensing Program Analyst (LPA) Adrian Mendez made an unannounced inspection to the facility and met with Residential Supervisor Tiffany Norris of Newport Academy-Morada to discuss the investigative findings for the allegation noted above. LPA conducted an inspection with the facility on October 13, 2022, at 9:46am. No deficiencies were noted. During the investigation, LPA interviewed three facility staff (S1, S2, S3), and four children (C1, C2, C3, C4). LPA also reviewed the facility staff's shift notes. On October 5, 2022, the Department received an allegation that staff did not prevent minors from engaging in sexual contact. It was reported that C1 and C2 were found in bed together. Based on confidential interviews, it was revealed that staff conduct bedroom checks every 15 minutes. Other confidential interviews revealed that staff conduct bedroom checks every 30 minutes to an hour. 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 - MORADAFACILITY NUMBER: VISIT DATE: 02/14/2023

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

met_with: Tiffany Norris


raw_content:
Narrative:
Specifically, it was stated that S3 & S4 became upset and made statements towards C1 and C2 such as "C2 came from the suburbs and to shut the fuck up". Confidential interviews denied S3 and S4 speaking to clients inappropriately and further denied that staff do not treat clients with dignity and respect. During the investigation, there was no corroborating evidence to support the allegations. In addition, C1, C2, and S4 was not able to be interviewed. Based on confidential interviews and records reviewed regarding the allegations that S3 and S4 spoke inappropriately to minors in care and that staff do not treat clients with dignity and respect, which may have occurred, however, it is not supported or proven by the evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, and a copy of this report along with appeal rights was provided to Administrator, Monica Garcia.

Investigation Findings:
13On March 6, 2025 at 8: AM, Licensing Program Analyst (LPA) Jacqueline Garcia arrived unannounced at the facility and met with Administrator, Monica Garcia, to discuss the investigative findings for the allegations noted above. On 08/29/ LPA conducted an inspection of the facility, and no deficiencies were noted. LPA interviewed three Clients (C3-C5), attempted to interview two clients (C1-C2), however after several attempts LPA did not receive a response, and three Staff (S1-S3) and attempted to interview one Staff (S4), however after several attempts LPA was unsuccessful to make contact. During the investigation, LPA reviewed facility client file's for C1 and C2. On 08/20/24, Community Care Licensing (CCL) received allegations staff inappropriately spoke to minor and staff does not treat client with dignity and respect. UnsubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Jacqueline Garcia 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 ORANGE COUNTY RO, THE CITY DR., SUITE FACILITY NAME: NEWPORT ACADEMY - MORADAFACILITY NUMBER: VISIT DATE: 03/06/2025

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

met_with: Monica Garcia-Administrator


raw_content:
Narrative:
****PAGE Based on confidential interviews and records reviewed, the preponderance of evidence standard has been met regarding the allegation that staff did not prevent C1 from accessing a knife while in care is found to be substantiated. The preponderance of evidence standard has been met. The facility is cited for violation of the California Code of Regulations, Title 22, 80087 (g)(1) Buildings and Grounds. An exit interview was conducted, and a copy of this report along with appeal rights was provided to Amanda Seymour. *****Page Continued. Confidential interviews and documents reviewed revealed the facility provides staff with client's information through shift reports and assessments. However, clients that left the facility without permission were unable to be interviewed to confirm that staff used emergency interventions to prevent clients from leaving the facility. Based on confidential interviews, the allegation that staff did not utilize the emergency intervention plan to prevent minors from AWOLING, may have occurred, however, it is not supported or proven by the evidence. Therefore, the allegation is unsubstantiated at this time. An exit interview was conducted, and a copy of this report along with appeal rights was provided to Amanda Seymour.

Investigation Findings:
13On March 28, 2025, at 3:00 p.m. Licensing Program Analyst (LPA) Jacqueline Garcia arrived to the facility and met with Residential Director, Amanda Seymour, to discuss the investigative findings for the allegation noted above. On 09/16/ LPA conducted an inspection of the facility, and no deficiencies were noted. LPA interviewed two clients (C1, C4), three staff (S1-S3), and attempted to interview two client (C2, C3) and one staff (S4) however was not able to reach them for interview. During the investigation, LPA reviewed facility client files, incident reports and program statement. SubstantiatedEstimated Days of Completion: SUPERVISORS NAME: Ann Valenzuela LICENSING EVALUATOR NAME: Jacqueline Garcia 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 ORANGE COUNTY RO, THE CITY DR., SUITE FACILITY NAME: NEWPORT ACADEMY - MORADAFACILITY NUMBER: VISIT DATE: 03/28/2025

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:

met_with: Amanda Seymour-Residential Director


summary: Facility Evaluation

raw_content:
Narrative:
On June 29, 2021, at 2:39PM Licensing Program Analysts (LPA's) Adrian Mendez and Jesus Cervantes conducted an unannounced annual continuation inspection from June 29, 2021. LPA met with Program Manager Claudia Jaimes. Employee files were not located at the facility and required employee files to be reviewed at Newport Academy-Sundance located at E. Sundance Circle, Orange, CA 92869. Five personnel files were reviewed to ensure they contained all required documentation per Title Regulations. Personnel Files are maintained off-site in the Human Resource office. All appropriate personnel who require caregiver background checks have received criminal record and child abuse index check clearances or exemptions. No deficiencies were noted during time of inspection. Based on file reviews this date, there are no deficiencies found at this time. A copy of this report was reviewed and given to Program Manager Claudia Jaimes.

met_with: Claudia Jaimes


summary: Facility Evaluation

raw_content:
Narrative:
On June 29, 2021 at 9:30am, Licensing Program Analysts (LPA's) Adrian Mendez and Jesus Cervantes arrived unannounced at the facility to conduct a Post-Licensing Annual inspection of the facility. The facility was inspected inside and out with Program Director Amanda Seymour, and Program Manager Ellen Asquith. The home is a one story residence with three bedrooms, three staff offices, two family therapy rooms, living room, one individual therapy office, a movie theater, one counselor's office, two classrooms, and nine bathrooms. The property also has a guest house located in the backyard of the facility which is used as a classroom. The client bedrooms are set up as follows: Bedroom #1; two twin beds, all required linen, mattresses in good condition. Bedroom #2; two twin beds, all required linen, mattresses in good condition. Bedroom #3; two twin beds, all required linen, mattresses in good condition. All bedrooms contained adequate shelf and closet space for resident's belongings. The staff offices contained office supplies, staff schedule and emergency and disaster plan that was posted. Medications and the first aid kit were locked in the medication room inside the hallway. Medication room has a locking door and a locking medication cabinet and refrigerator within the room. Medication logs are maintained electronically and had no discrepancies. The bathrooms were clean and in good repair. Water temperature in the kitchen sink of the property was measured at 11:33am and read at 108.3 degrees. The property contains a pool and an adjoining spa in the backyard which is fenced and covered. The fence and gate around the pool is five feet tall, and is self latching. Cont. on 809-C All hazardous items were made inaccessible to areas where residents do not have access. Cleansers/chemicals were stored in a locked cabinet in the garage, and a locked cabinet in the laundry room. Sharp knives were inaccessible and stored in a locked drawer in the kitchen. LPA's observed a sufficient supply of 7-day non-perishable food for six residents and a sufficient supply of 2-day perishable food. There was a variety of snacks available for residents as well. The facility outside grounds was also inspected and it was observed to be clean and well maintained. Emergency exits were free from obstruction. The facility's smoke/carbon monoxide detectors in the hallways were checked and were operable. There were no guns or weapons in the facility as stated by Program Director. The following required posted items were observed accessible to clients: Grievance Procedures, Personal Rights, Visitation policies, Disaster Plan, Employee Schedule and current menu. A sample of five client files were reviewed during the inspection. A review of administrative records indicate that the facility has paid their current licensing fees. Due to time restraints and facility staff files being maintained at an off site location, LPA will review facility staff files at a later time. Based on the facility inspection and file reviews this date, there are no deficiencies found at this time. A copy of this report was reviewed and given to Program Director Amanda Seymour.