306005154-4-5-2024-22-AS-SSAS-D4M29R-20240423171223

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005154
Report Date: 04/05/2024
Date Signed: 04/05/2024 03:47:30 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/29/2024 and conducted by Evaluator Joseph Alejandre

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20240329103030

FACILITY NAME:	NEWPORT BEACH MEMORY CARE		FACILITY NUMBER:	306005154
ADMINISTRATOR:	SANCHEZ, EILEEN		FACILITY TYPE:	740
ADDRESS:	1000 HALYARD		TELEPHONE:	(949) 220-9700
CITY:	NEWPORT BEACH	STATE: CA	ZIP CODE:	92663
CAPACITY:	42	CENSUS: 30	DATE:	04/05/2024
		UNANNOUNCED	TIME BEGAN:	02:04 PM
MET WITH:	Riley Bushman		TIME COMPLETED:	04:07 PM

ALLEGATION(S):

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Staff did not properly safeguard confidential information

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to conduct the required 10-day visit to begin the investigation into the allegations listed above. LPA met with Operations Manager Riley Bushman and explained the reason for the visit. LPA observed the See Something Say Something Poster posted in the entrance of the facility. LPA did not observe any confidential information at the front desk. The investigation into the allegation revealed the following. It was reported that the facility census was left out in public view. LPA interviewed staff. LPA and Operations Manager toured the facility. 4 out of 4 staff interviewed had no knowledge of confidential information not being properly safeguarded or being left out in public view. During the tour of the facility LPA did not observe any Title 22 violations including confidential information not being safeguarded. Based on the information gathered the allegation, staff did not properly safeguard confidential information is deemed unsubstantiated. Although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violation did or did not occur. An exit interview was conducted and a copy of the report provided.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Sheila Santos	TELEPHONE: (714) 334-2062
LICENSING EVALUATOR NAME: Joseph Alejandre	TELEPHONE: 714-705-6018
LICENSING EVALUATOR SIGNATURE:	DATE: 04/05/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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