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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306006180
Report Date: 03/15/2024
Date Signed: 03/15/2024 04:10:43 PM


Document Has Been Signed on 03/15/2024 04:10 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
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868



FACILITY NAME:VIVANTE NEWPORT CENTERFACILITY NUMBER:
306006180
ADMINISTRATOR:FOOTE, LIANAFACILITY TYPE:
740
ADDRESS:850 SAN CLEMENTE DRTELEPHONE:
(760) 547-2863
CITY:NEWPORT BEACHSTATE: CAZIP CODE:
92660
CAPACITY:150CENSUS: 107DATE:
03/15/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Bob Fiorentino, Executive DirectorTIME COMPLETED:
04:20 PM
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On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of a case management visit following up on an incident report submitted on March 12, 2024 by facility administrator Mirella Majarez. LPA was greeted and granted entry by Executive Director Bob Fiorentino after stating the purpose of the visit.

Following allegations of verbal threats of a sexual nature made by a facility resident towards another facility resident, reports were made to the Newport Beach Police Department (report number pending) as well as to the facility's assigned Long Term Care Ombudsman. The Police Department came to investigate on March 4, 2024 and the Ombudsman on March 8, 2024. Interviews with the involved parties were made. It was also recommended that lab tests were conducted on the involved residents to rule out a potential instance of a cognitive symptoms associated to a Urinary Tract Infection. Tests for one resident came back negative and the other resident's are pending.

There have been no further incidents or instances at this time.

An exit interview was conducted and a copy of this report was provided to a facility representative.
SUPERVISOR'S NAME: Sheila SantosTELEPHONE: (714) 334-2062
LICENSING EVALUATOR NAME: Kevin Saborit-GuaschTELEPHONE: (714) 497-8754
LICENSING EVALUATOR SIGNATURE:
DATE: 03/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/15/2024
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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