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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 565850253
Report Date: 06/05/2026
Date Signed: 06/05/2026 02:07:32 PM

Document Has Been Signed on 06/05/2026 02:07 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
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME:NEWPORT INSTITUTE - ALHAMBRAFACILITY NUMBER:
565850253
ADMINISTRATOR/
DIRECTOR:		VACA, LEOPOLDOFACILITY TYPE:
772
ADDRESS:2565 ALHAMBRA COURTTELEPHONE:
(714) 393-3523
CITY:SANTA ROSA VALLEYSTATE: CAZIP CODE:
93012
CAPACITY: 6CENSUS: 4DATE:
06/05/2026
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Regan MewTIME VISIT/
INSPECTION COMPLETED:
02:15 PM
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Licensing Program Analyst (LPA) Martha Arroyo conducted an unannounced required annual inspection at the facility today at 09:00am. Upon arrival, the LPA met with Operations Clinical Specialist, Lacey Yukelson and explained the reason for the visit. Staff contacted the Compliance Specialist, Regan Mew, and informed them of the visit. The Compliance Specialist arrived during the inspection. Entrance interview.

Starting at 09:12am, the LPA, along with staff, toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. The following was observed:

KITCHEN: The kitchen/ food service area was inspected at 09:33am. Appliances and fixtures appeared clean and functional. There was a sufficient supply of nonperishable food and perishable food. Foods were labeled and checked for expiration dates. Knives and other sharps are stored in a locked box inside the staff office. Cleaning supplies were observed under the kitchen sink locked and inaccessible. There were no visible immediate hazards observed.

BEDROOMS: There are three (3) bedrooms for client use, all of which are designated as shared/double occupancy room. All bedrooms were equipped and supplied with appropriate furniture, bedding and linens, as well as emergency lighting. There were no visible hazards or discrepancies observed.

Report Continued on LIC 809C...

NAME OF LICENSING PROGRAM MANAGER: Desaree Perera
NAME OF LICENSING PROGRAM ANALYST: Martha Arroyo
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/05/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/05/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: NEWPORT INSTITUTE - ALHAMBRA
FACILITY NUMBER: 565850253
VISIT DATE: 06/05/2026
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Report Continued from LIC 809...

BATHROOMS: There are five (5) total bathrooms, two (2) on the ground floor and three (3) on the second floor. Four (4) restrooms are designated for client use and one (1) is designated as a staff bathroom. Bathrooms were clean, sanitary, and in operating condition. Water temperature was measured in client bathrooms and measured within the required range of 105 F to 120 F at the time of the visit. Personal hygiene items are kept in a locked cabinet.

COMMON AREAS: On the first floor, include the living room, dining room, learning lab, therapist room, and gym. On the second floor, there is separate therapist room. The LPA observed a fireplace, which was adequately screened. All furniture appeared clean and in good condition. Fire extinguishers were observed throughout the facility; all were observed to be fully charged and last serviced on 01/26/2026. An adequate amount of emergency food and water supply was observed at the time of the visit. There is an emergency evacuation chair by the stairs.

LAUNDRY: The locked laundry room is located on the ground floor. Detergents and cleaning supplies were observed to be inside a locked closet in the locked laundry room. The LPA observed an adequate amount of Personal Protection Equipment (PPE) at the time of the visit. There were no immediate hazards observed.

SURROUNDING GROUNDS: There is a shaded area equipped with adequate outdoor furniture for client use. There are two gates on each side of the house designated for emergency exits. The LPA observed a basketball court accessible to clients. There is a barn located in the back perimeter which was observed to be locked and inaccessible at the time of the visit. All passageways were free and clear from obstruction. The LPA observed an in-ground pool with fencing and a locked gate which was inaccessible to clients at the time of the visit. No immediate hazards were observed outdoors.

MEDICATION REVIEW: Medications are centrally stored in the locked room on the ground level. At approximately 12:15pm, medications were reviewed for two (2) clients. Medications observed were properly labeled. The LPA observed the centrally stored medication and destruction records (CSMDRs) complete. Medications appear to be administered as prescribed at the time of the visit.

Report Continued on LIC 809C...

NAME OF LICENSING PROGRAM MANAGER: Desaree Perera
NAME OF LICENSING PROGRAM ANALYST: Martha Arroyo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/05/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2026
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: NEWPORT INSTITUTE - ALHAMBRA
FACILITY NUMBER: 565850253
VISIT DATE: 06/05/2026
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Report Continued from LIC 809C..,.

RECORD REVIEW: Staff and client files are stored electronically. Beginning at 09:40am, LPA reviewed four (4) out of four (4) client files and three (3) staff files for documents including, but not limited to: admission agreements, health screening, TB test, staff training records, fingerprint clearance, needs and service care plan, personal rights, and first aid/CPR training. All staff and client records reviewed were in compliance with Title 22 regulations at the time of the visit.

INFECTION CONTROL/EMERGENCY DISASTER PLANNING: During today’s visit, LPA reviewed the facility's infection control policy and emergency disaster plan. The last fire safety inspection was completed on 08/27/2025 and sprinkler system inspection on 11/04/2025; both were found to be in compliance with Fire Code Regulations at the time of inspections.

No deficiencies cited at this time. Exit interview conducted. A copy of the report was provided.

NAME OF LICENSING PROGRAM MANAGER: Desaree Perera
NAME OF LICENSING PROGRAM ANALYST: Martha Arroyo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/05/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2026
LIC809 (FAS) - (06/04)
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