New Haven

Type of visit: Required - 1 Year

On 05/29/2026, at 09:00 AM, Licensing Program Analyst (LPA) James Sampair arrived unannounced to conduct this Required Annual inspection. Upon entry, the LPA stated the purpose of the visit to Caregiver Marilou Ladaban.. The LPA toured the facility, including but not limited to residents’ rooms, bathrooms, kitchen, common areas, and the yard. The LPA observed adequate lighting for the comfort and safety of residents in all rooms. The walkways in both the interior and exterior of the facility are free from obstructions. There are no bodies of water. The temperature of the refrigerators was below 40 degrees Fahrenheit and the freezers below 0 degrees Fahrenheit. At 10:58 AM, the dining room temperature was measured; it was 72.1 degrees Fahrenheit. At 11:13 AM, the maximum hot water temperature was measured in the kitchen; it was 113.9 degrees Fahrenheit. The residents’ bathrooms are equipped with grab bars and slip-resistant mats. There is more than a 7-day supply minimum of nonperishable foods and a 2-day of perishable foods. The LPA observed the required postings in the facility, except for the 20" x 26" Residential Care Facility for the Elderly (RCFE) Complaint Poster (PUB 475). Smoke detectors and carbon monoxide detectors were tested and found to be in operating condition. The fire extinguisher was fully charged and last replaced on 06/22/2025. The Emergency Disaster Plan was reviewed within the past year; the most recent review was on 01/09/2026. No record of emergency, disaster, and fire drills being conducted on a quarterly basis. First aid kit was observed to be complete. Liability insurance expires on 02/02/2027. Continued on LIC 809-C . . . . . . Continued from LIC 809 The LPA reviewed 5 Resident, 4 Staff, and Facility records. The following citations were issued during the inspection: Personnel Records/Staff Training - Type B: Title 22 87412(f) - no administrator records at facility Personnel Records/Staff Training - Type B: HSC 1569.625(b)(2) - inadequate proof that 4 of 4 staff completed all 20 hours of training Disaster Preparedness - Type B: HSC 1569.695(c) - no written proof of quarterly drills A total of three (3) citations (3 Type B) were issued for deficiencies during this inspection. Deficiencies are cited per Title 22 California Code of Regulations and listed on LIC 809-D. Failure to submit Proof of Corrections (POCs) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, May 29, 2026

Type of visit: Required - 1 Year

On 5/9/2025, at 1:30 PM, Licensing Program Analyst (LPA) James Sampair arrived unannounced to conduct the Required Annual Inspection of the facility. Upon arrival, LPA stated the purpose of the visit to Lead Staff Marilou Ladaban. The LPA toured the interior and exterior of the facility, inspecting the kitchen, food and emergency supply storage areas, dining area, shared restrooms, community living spaces, client rooms, and the grounds of the facility. More than the required minimum of 7 days of nonperishable and 2 days of perishable foods were appropriately stored. The maximum hot water temperature was 130 degrees Fahrenheit (above 120 degrees safe temperature) and the temperature in the common area was 80 degrees Fahrenheit. The carbon monoxide and smoke detectors were fully operational. The fire extinguisher was last serviced on 5/14/2025. The LPA observed postings in the facility that included a complaint poster, Ombudsman, and Personal Rights posters. An administrator is on site more than the minimum of 20 hours a week to oversee the proper business operations. The LPA reviewed facility records, records of 4 staff members, and records of 5 residents. 1 Type-A citation issued during the inspection (refer to LIC 809-D for details). Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, May 9, 2025

Type of visit: Case Management - Annual Continuation

On 05/24/2024 at 8:30 AM, Licensing Program Analyst (LPA) James Sampair arrived unannounced to complete the Required Annual Inspection that began 5/13/2024. Upon entry, LPA disclosed the purpose of the visit with Lead Staff Marilou Ladaban. The LPA completed review of facility records and reviewed records of 5 staff members. No citations issued during this inspection. Annual inspection complete. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, May 24, 2024

Type of visit: Required - 1 Year

On 05/13/2024 at 1:00 PM, Licensing Program Analyst (LPA) J. Sampair arrived unannounced to conduct the Required Annual Inspection. Upon entry, LPA disclosed the purpose of the visit with Lead Staff Marilou Ladaban. The LPA inspected the interior and exterior of the facility that included the kitchen, dining area, restrooms, community living spaces, resident rooms, storage areas, and the grounds of the facility. More than the required minimum of 7 days of nonperishable and 2 days of perishable foods were appropriately stored. Temperature in the living room was measured at 71.4 degrees Fahrenheit at 3:28 PM. The LPA observed postings in the facility that included a complaint poster, Ombudsman and Personal Rights posters, Theft and Loss Policy, Rights to Resident Council, and Rights to Family Council. The carbon monoxide and smoke detector were tested and found to be fully operational. 3 fire extinguishers were fully charged, but the facility was cited because they had not been serviced since 9/8/2022. An administrator is on site more than the minimum of 20 hours a week to oversee the proper business operations. The LPA reviewed records of 5 residents. The LPA interviewed 2 staff members and 2 residents. During the inspection, 2 B-Type citations were issued (refer to LIC809-D for details). Annual inspection incomplete. LPA will return unannounced at a future date and time to complete the inspection. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, May 13, 2024