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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079201421
Report Date: 01/13/2025
Date Signed: 01/13/2025 01:54:16 PM

Document Has Been Signed on 01/13/2025 01:54 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND ASC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME:NEWPORT INSTITUTE-WILLOW HILLFACILITY NUMBER:
079201421
ADMINISTRATOR/
DIRECTOR:		ZAMBRANO, ALVAROFACILITY TYPE:
772
ADDRESS:1400 LAWRENCE RDTELEPHONE:
(714) 393-3523
CITY:DANVILLESTATE: CAZIP CODE:
94506
CAPACITY: 6CENSUS: 0DATE:
01/13/2025
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:30 PM
MET WITH:Program Manager, Alvaro ZambranoTIME VISIT/
INSPECTION COMPLETED:
02:15 PM
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On 1/13/2025 at 1:30 PM, Licensing Program Analyst (LPA) A. Gomez arrived announced to re-conduct the Pre-Licensing visit. LPA met with Program Manager, Alvaro Zambrano and Compliance Specialist, Fausto Arambuo and explained the purpose of the visit. The facility currently has no clients.

LPA toured facility with Program Manager and Compliance Specialist including but not limited to 4 bedrooms, 5 bathrooms, kitchen, office spaces, common areas and backyard. Bedrooms include the required bedding, chair, and additional lighting. Facility has additional linens and hygiene supplies. There is sufficient lighting throughout facility. Room temperature was maintained at 69 degrees F and hot water temperature was maintained at 117 degrees F. First-aid kit was observed to be complete. Smoke detectors and carbon monoxide were operational. Fire extinguisher was last serviced on 12/13/2024.

No issues noted during inspection. LPAs observed that facility is ready to be licensed. This report will be submitted to the Central Applications Unit (CAU) and a final review of the application will be conducted. This facility is not yet licensed, and is subject to final approval by CAU. Additional requirements may still be required.

Comp III Conducted

Exit interview conducted and a copy of this report provided.
SUPERVISORS NAME: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Alona Gomez
LICENSING EVALUATOR SIGNATURE: DATE: 01/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/13/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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