<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306006059
Report Date: 01/03/2025
Date Signed: 01/03/2025 12:54:20 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY ASC, 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
12/26/2024 and conducted by Evaluator Dwayne L Mason
COMPLAINT CONTROL NUMBER: 22-AS-20241226150858
FACILITY NAME:NEWPORT INSTITUTE - CERRO VISTAFACILITY NUMBER:
306006059
ADMINISTRATOR:APOSTU, DIANAFACILITY TYPE:
772
ADDRESS:160 S. CERRO VISTA WAYTELEPHONE:
(714) 393-3523
CITY:ANAHEIMSTATE: CAZIP CODE:
92807
CAPACITY:6CENSUS: 3DATE:
01/03/2025
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Kristen Riha - Clinical DirectorTIME COMPLETED:
01:09 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility did not ensure admissions agreement was signed by client.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
This unannounced investigation inspection by Licensing Program Analyst (LPA) Dwayne Mason Jr. is being conducted to conclude this agency’s investigation in the complaint allegation(s) mentioned above. LPA arrived at the facility and was greeted by facility staff. LPA spoke with Clinical Director Kristen Riha and explained the nature of the inspection.

The department received a complaint on 12/26/2024 alleging the facility did not ensure admissions agreement was signed by client. During the investigation, the department interviewed facility staff.

(continued on LIC9099-C)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Dwayne L Mason
LICENSING EVALUATOR SIGNATURE:

DATE: 01/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/03/2025
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 5
Control Number 22-AS-20241226150858
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY ASC, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: NEWPORT INSTITUTE - CERRO VISTA
FACILITY NUMBER: 306006059
VISIT DATE: 01/03/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
(continued from LIC9099)

On 1/3/2024 LPA conducted a visit to the facility to initiate investigation into the above allegation. LPA obtained the following documents: resident roster, staff roster and client admission paperwork. LPA reviewed admission paperwork for three clients (C1, C2, C3). Based on these documents, LPA determined that C1 and C2 signed their admission paperwork within seven calendar days of their admission. LPA determined C3 was admitted on 11/13/2024 and signed their admission paperwork on 12/6/2024. LPA conducted an interview with Staff 2 (S2). S2 stated that there was an error in following up with C3 to acquire their signature in a timely manner.

Based on documents reviewed and interviews, the LPA determined the facility did not acquire C3's signature on their admission paperwork within seven calendar days of admission. The preponderance of evidence standard has been met. The allegation of "Facility did not ensure admissions agreement was signed by client" is determined to be SUBSTANTIATED, meaning the complaint allegation is valid and that a violation has occurred. An exit interview was conducted, and this report was reviewed with facility staff. A copy of this LIC-9099, deficiency page and appeal rights were provided to the facility.
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Dwayne L Mason
LICENSING EVALUATOR SIGNATURE:

DATE: 01/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/03/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 22-AS-20241226150858
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY ASC, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: NEWPORT INSTITUTE - CERRO VISTA
FACILITY NUMBER: 306006059
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/03/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/17/2025
Section Cited
CCR
81068(d)
1
2
3
4
5
6
7
Admission Agreements 81068 (d) Such agreements shall be dated and signed, acknowledging the contents of the document, by the client and the client's authorized representative and the licensee or the licensee's designated representative no later than seven
1
2
3
4
5
6
7
The Clinical Director stated they will conduct an in-service training with staff on client admissions. The CD stated they will document the date/time of the training, topics covered and staff in attendance of the training. CD stated they will email the aforementioned documentation to the LPA by
8
9
10
11
12
13
14
calendar days following admission.

The Licensee did not comply with the section cited above due to the presence of a client admission agreement which indicated the client did not sign the agreement within seven calendar days of admission.
8
9
10
11
12
13
14
the assigned POC due date of 1/17/2025.
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Armando J Lucero
LICENSING EVALUATOR NAME: Dwayne L Mason
LICENSING EVALUATOR SIGNATURE:

DATE: 01/03/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/03/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY ASC, 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
12/26/2024 and conducted by Evaluator Dwayne L Mason
COMPLAINT CONTROL NUMBER: 22-AS-20241226150858

FACILITY NAME:NEWPORT INSTITUTE - CERRO VISTAFACILITY NUMBER:
306006059
ADMINISTRATOR:APOSTU, DIANAFACILITY TYPE:
772
ADDRESS:160 S. CERRO VISTA WAYTELEPHONE:
(714) 393-3523
CITY:ANAHEIMSTATE: CAZIP CODE:
92807
CAPACITY:6CENSUS: 3DATE:
01/03/2025
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Kristen Riha - Clinical DirectorTIME COMPLETED:
01:09 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility did not follow program plan due to not following discharge procedure.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
This unannounced investigation inspection by Licensing Program Analyst (LPA) Dwayne Mason Jr. is being conducted to conclude this agency’s investigation in the complaint allegation(s) mentioned bove. LPA arrived at the facility and was greeted by facility staff. LPA met with Clinical Director Kristen Riha and explained the nature of the inspection.

The department received a complaint on 12/26/2024 alleging the facility did not follow program plan due to not following discharge procedure. During the investigation, the department interviewed staff.

(continued on LIC9099-C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Dwayne L Mason
LICENSING EVALUATOR SIGNATURE:

DATE: 01/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/03/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 22-AS-20241226150858
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY ASC, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: NEWPORT INSTITUTE - CERRO VISTA
FACILITY NUMBER: 306006059
VISIT DATE: 01/03/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
(continued from LIC9099)

On 1/3/2025 LPA conducted a visit to the facility to initiate investigation into the above allegation. LPA obtained copies of the resident roster, staff roster and discharge letters. LPA reviewed a discharge letter for Client 4 (C4) and a discharge letter for Client 5 (C5). LPA observed C4 signed their discharge letter on 11/1/2024 and the Discharge Planner signed it on 11/7/2024. LPA observed C5 signed their discharge letter on 11/10/2024 and the Discharge Planner signed it on 11/13/2024. LPA interviewed 3 staff (S1, S2, S3). 3 out of 3 staff stated that, C4's discharge was an unexpected discharge. 3 out of 3 staff stated that, C5's discharge occurred on a weekend. 3 out of 3 staff stated that the Discharge Planner may not be available to review the discharge paperwork with clients if there is an unexpected discharge or if the discharge occurs on a weekend. 3 out of 3 staff stated that, if the Discharge Planner is unavailable at the time of discharge, an available staff member will review the discharge letter with the client.

LPA advised the facility to document who reviews the discharge letter with the client if the Discharge Planner is unavailable. LPA issued a Technical Advisory (TA).

Based on observations, interviews conducted and records reviewed there is insufficient evidence to support the allegation of "Facility did not follow program plan due to not following discharge procedure." Although the allegation(s) may have happened or is valid; there is not a preponderance of evidence to prove that the alleged violation(s) did or did not occur, therefore the allegation is UNSUBSTANTIATED.

An exit interview was conducted, and this report was reviewed with facility staff. A copy of this LIC-9099 was provided to the facility.
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Dwayne L Mason
LICENSING EVALUATOR SIGNATURE:

DATE: 01/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/03/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5