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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 216804061
Report Date: 01/29/2024
Date Signed: 01/29/2024 10:36:00 AM

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
01/22/2024 and conducted by Evaluator Caitlynn Felias
COMPLAINT CONTROL NUMBER: 21-AS-20240122162253
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:
01/29/2024
UNANNOUNCEDTIME BEGAN:
09:35 AM
MET WITH: Clinical Counselor, Melissa Newton, and Clinical Director, Rae TurnerTIME COMPLETED:
09:44 AM
ALLEGATION(S):
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Licensee is not revealing the license number in all advertisements.
INVESTIGATION FINDINGS:
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At approximately 9:35AM, Licensing Program Analyst (LPA) Felias arrived unannounced to initiate a Complaint Investigation regarding the above allegation and met with Clinical Counselor, Melissa Newton. Clinical Director, Rae Turner, arrived during visit at approximately 9:45AM.

During the course of the Investigation, LPA reviewed documents and made observations. There is an allegation that the Licensee is not revealing the license number in all advertisements. Reporting Party stated that the facility advertises its program in the Greet CDM Magazine but does not advertise the license number. LPA observed that the magazine's QR code leads directly to the Licensee website but does not show any license numbers listed for their advertised programs. Based on documents reviewed and observations made, this allegation is substantiated.

Continued on LIC9099
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Caitlynn Felias
LICENSING EVALUATOR SIGNATURE:

DATE: 01/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2024
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-20240122162253
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: 01/29/2024
NARRATIVE
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Continued from LIC9099

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 Clinical Director. Copy of report, LIC9099D, Plan of Corrections, and Appeal Rights discussed and provided to Clinical Director. Signature on form confirms receipt of documents.
SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Caitlynn Felias
LICENSING EVALUATOR SIGNATURE:

DATE: 01/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 21-AS-20240122162253
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: 01/29/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/08/2024
Section Cited
CCR
81011(a)
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81011 Advertisements and License Number (a) Licensees shall reveal each facility license number in all advertisements in accordance with Health and Safety Code section 1514.
This requirement was not met as evidenced by: based on review of documents and
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Licensee to ensure that all advertisements marketing the program list the license number associated to the facility. Licensee to submit proof that the facility license number is present in their advertisements by POC due date of 02/08/2024.
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observations made, the Licensee did not comply with the section cited above. Licensee did not ensure that the facility license number was advertised in a magazine as required. This poses a potential health, safety, or personal rights risk to clients in care.
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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: 01/29/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3