331881305-5-7-2026-18-AS-JDHS-DTVVLD-20260508163147

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 331881305
Report Date: 05/07/2026
Date Signed: 05/07/2026 11:33:05 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/24/2023 and conducted by Evaluator Jarred Torres

COMPLAINT CONTROL NUMBER: 18-AS-20230324153646

FACILITY NAME:	NEWPORT INSTITUTE- SHADY CREEK		FACILITY NUMBER:	331881305
ADMINISTRATOR:	LIPPELGOOS, SABRINA		FACILITY TYPE:	772
ADDRESS:	43821 SHADY CREEK		TELEPHONE:	(714) 393-3523
CITY:	TEMECULA	STATE: CA	ZIP CODE:	92590
CAPACITY:	6	CENSUS: 5	DATE:	05/07/2026
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Clinical Director, Greg Young		TIME COMPLETED:	11:45 AM

ALLEGATION(S):

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Facility did not provide adequate supervision to resident.

INVESTIGATION FINDINGS:

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On May 7, 2026, Licensing Program Analyst (LPA), Jarred Torres, arrived unannounced at the facility to deliver the finding pertaining to the alleged complaint. LPA met with Clinical Director (CD), Greg Young, and explained the purpose of the visit was to deliver findings for the investigation.

On March 24, 2024, Community Care Licensing received a complaint alleging that the facility did not provide adequate supervision for a resident. It was alleged that the facility did not adequately supervise Resident #1 (R1).

An interview with former Program Director (PD), Kenyota Dokes, revealed that the facility offered R1 various forms of supervision and care. PD confirmed that all residents are placed on a 1:1 supervision plan until enough improvement is documented to put the residents on a regular supervision plan.

Continued on LIC 9099-C...

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Jarred Torres
LICENSING EVALUATOR SIGNATURE:	DATE: 05/07/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2026

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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Control Number 18-AS-20230324153646

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: NEWPORT INSTITUTE- SHADY CREEK	FACILITY NUMBER: 331881305
	VISIT DATE: 05/07/2026

NARRATIVE

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Additionally, PD explained that the facility offered care and supervision through the use of daily journals, therapy sessions, and counseling sessions. PD stated that R1 utilized all the resources available to receive proper care and supervision. An interview with former Program Manager (PM), Lorren Larken, corroborates the information that PD provided. During an interview with R1, it was reported due to R1’s improved behaviors, R1 did not require 1:1 supervision. R1 stated adjustments were made after incidents, but there was no concern regarding a lack of supervision. A review of R1's therapy, counseling, and care plan records revealed that R1 utilized the facility's resources to improve their condition. LPA was unable to interview any additional pertinent witnesses.

Due to similar statements from facility staff that adequate supervision was provided, R1’s statements suggesting that the care and supervision resulted in improvement, a review of the aforementioned documents, and a lack of physical evidence to support the allegation, this allegation is deemed unsubstantiated. This means that although the allegation may be valid or has happened, the preponderance of evidence standard requirement has not been met to show that the violation did or did not occur.

An exit interview was conducted, and this report was reviewed with and provided to Clinical Director, Greg Young, whose signature on this form confirms receipt.

SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Jarred Torres
LICENSING EVALUATOR SIGNATURE:	DATE: 05/07/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2026

LIC9099 (FAS) - (06/04)

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