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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 216804061
Report Date: 01/12/2024
Date Signed: 01/12/2024 03:04:15 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/10/2023 and conducted by Evaluator Caitlynn Felias
COMPLAINT CONTROL NUMBER: 21-AS-20231010145208
FACILITY NAME:NEWPORT INSTITUTE - BAYVIEWFACILITY NUMBER:
216804061
ADMINISTRATOR:MAXWELL KELLERFACILITY TYPE:
772
ADDRESS:285 MARGARITA DRIVETELEPHONE:
(714) 393-3523
CITY:SAN RAFAELSTATE: CAZIP CODE:
94901
CAPACITY:6CENSUS: 5DATE:
01/12/2024
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Residential Supervisor, Hope HurstTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Personal Rights
INVESTIGATION FINDINGS:
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At approximately 9:30AM, Licensing Program Analyst (LPA) Felias arrived unannounced to continue a Complaint Investigation regarding the above allegation and met with Residential Supervisor, Hope Hurst.

During the course of the Investigation, LPA requested and reviewed documents, and conducted interviews. There is an allegation of Personal Rights where the Reporting Party alleged that Client 1 (C1) was not allowed to use a cell phone to contact the police during a facility outing to the grocery store. Based on staff interviews, LPA confirmed that clients have been unable to use their phone to contact police/local authorities. Staff interviews conducted stated that clients can contact local authorities by using a staff member’s phone but the situation would need to be evaluated first and staff would need to give permission first. Interviews also stated that if clients want to contact the police, they are to inform a staff member or supervisor, inform staff of why the phone call needs to be made, and have the phone call be supervised.

Continued on LIC9099C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Caitlynn Felias
LICENSING EVALUATOR SIGNATURE:

DATE: 01/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 21-AS-20231010145208
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: NEWPORT INSTITUTE - BAYVIEW
FACILITY NUMBER: 216804061
VISIT DATE: 01/12/2024
NARRATIVE
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Continued from LIC9099C

Review of Facility’s Program Plan for phone calls stated the following procedures: “Upon admission and throughout their stay, residents have the right to make phone calls. Staff remain outside the office or within close range of the resident to monitor behavior, without listening to content of the call. Any call to/from a person that falls within the essential category (authorized representative, family members, clergy, attorney, social worker) may only be restricted during therapeutic programing and academic hours except in the case of emergencies or when there is short-term crisis at the facility. Non-essential (anyone other than essential) calls are made outside of program and academic hours.” Review of C1’s Admissions Agreement – Client Rights stated the following, “Each client shall have the rights:…to make and receive confidential telephone calls…(unless prohibited by court order).” Based on record review and interviews conducted, this allegation is Substantiated.

A finding that the complaint allegation is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met.



Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiencies, on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

Exit interview conducted. Plan of Corrections reviewed and developed with Residential Supervisor. Copy of report, LIC9099D, Plan of Corrections, and Appeal Rights discussed and provided Residential Supervisor. Signature on form confirms receipt of documents.

SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Caitlynn Felias
LICENSING EVALUATOR SIGNATURE:

DATE: 01/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 21-AS-20231010145208
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: NEWPORT INSTITUTE - BAYVIEW
FACILITY NUMBER: 216804061
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/12/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/22/2024
Section Cited
CCR
81072(a)(19)
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81072 Personal Rights: (a)Each client shall have personal rights...(19) To have access to telephones in order to make and receive confidential calls provided that such calls... do not restrict availability of the telephone during emergencies. This requirement was not met as evidenced by: based on record
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Licensee to ensure the facility plan of operation is followed. Licensee to conduct In-service Training and review phone call procedures and personal rights of clients with management and care staff team. In-service Training to include: Date of Training, Training Topics, Job Role, Staff Names, and
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review and interviews conducted, the Licensee did not comply with the section cited above. Clients are not able to contact essential personnel like police by telephone when they want to. This poses a potential health, safety or personal rights risk to clients in care.
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Signatures by POC due date of 01/22/2024.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Caitlynn Felias
LICENSING EVALUATOR SIGNATURE:

DATE: 01/12/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3