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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 097002991
Report Date: 02/10/2025
Date Signed: 02/10/2025 09:58:17 AM

Document Has Been Signed on 02/10/2025 09:58 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:NEW WEST HAVEN IIFACILITY NUMBER:
097002991
ADMINISTRATOR/
DIRECTOR:		TANIA LANGLANDFACILITY TYPE:
740
ADDRESS:2551 CAMEO DRIVETELEPHONE:
(530) 677-2979
CITY:CAMERON PARKSTATE: CAZIP CODE:
95682
CAPACITY: 67TOTAL ENROLLED CHILDREN: 0CENSUS: 38DATE:
02/10/2025
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Med Tech Jessica MaranvilleTIME VISIT/
INSPECTION COMPLETED:
10:10 AM
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Licensing Program Analyst (LPA) Lavinia Muscan arrived on Monday February 10, 2025 to conduct a case management visit to ensure the facility is following the stipulation and waiver.

LPA Muscan reviewed the probation binder. LPA confirmed with the Med Tech that facility is complying with probation conditions. LPA toured the home. The home is well maintained and residents appeared to have needs met.

No deficiencies cited. Exit interview conducted. A copy of this report was provided to Med Tech.

Laura MunozTELEPHONE: (916) 263-4743
Lavinia MuscanTELEPHONE: 916-263-4700
DATE: 02/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/10/2025
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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