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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 097003240
Report Date: 04/07/2022
Date Signed: 04/07/2022 04:08:25 PM

Document Has Been Signed on 04/07/2022 04:08 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, 520 COHASSET RD., STE. 170
CHICO, CA 95926
FACILITY NAME:NEW WEST HAVEN II (ADC)FACILITY NUMBER:
097003240
ADMINISTRATOR:REBECCA LEIKAUFFACILITY TYPE:
775
ADDRESS:2551 CAMEO LANETELEPHONE:
(888) 852-5930
CITY:CAMERON PARKSTATE: CAZIP CODE:
95682
CAPACITY: 28CENSUS: 0DATE:
04/07/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Tania LanglandTIME COMPLETED:
11:30 AM
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LPA Smith spoke with New West Haven II administrator, Tania Langland. Facility has been non-operational for over 2 years in part, due to the pandemic.

Facility is not scheduled to reopen anytime in the near future. Facility is concentrating on the assisted living portion of the facility due to the substantial increase in residents there.

Administrator / Licensee shall contact Community Care Licensing representative Michael Smith, at the below referenced number upon reopening.
SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Michael Smith
LICENSING EVALUATOR SIGNATURE: DATE: 04/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/07/2022
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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