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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 435202428
Report Date: 11/12/2025
Date Signed: 11/12/2025 10:46:40 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/04/2025 and conducted by Evaluator Murial Han
PUBLIC
COMPLAINT CONTROL NUMBER: 26-AS-20250804104755
FACILITY NAME:STONE HAVEN CAREFACILITY NUMBER:
435202428
ADMINISTRATOR:CHIDI IKEMEFACILITY TYPE:
735
ADDRESS:578 N. MATHILDA AVE.TELEPHONE:
(408) 481-9920
CITY:SUNNYVALESTATE: CAZIP CODE:
94085
CAPACITY:33CENSUS: 30DATE:
11/12/2025
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Administration Assistant, Lorraine BacaTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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Staff did not address resident smoking illegal drugs in the facility
Staff did not ensure that sharp objects were inaccessible to residents in care
Staff do not ensure that resident hygiene needs are met
INVESTIGATION FINDINGS:
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On 11/12/2025, Licensing Program Analyst (LPA) Murial Han conducted an unannounced complaint visit to deliver the investigation findings. LPA met with the Administration Assistant, Lorraine Baca explained the purpose of the visit. The Administration Assistant called and informed the Administrator of LPA's visit.

Regarding to the allegation of - staff did not address resident smoking illegal drugs in the facility, the reporting party stated that resident- in-question( R1) was smoking meth in the facility and has been caught by staff but nothing was done.

As part of the investigation, the department interviewed the administrator, staff members, attempted to interview R1 and other residents.

The administrator denied the allegation and stated that the facility has zero- tolerance for drugs and alcohol. The administrator also denied residents bringing in or doing drugs in the facility.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Cara Smith
LICENSING EVALUATOR NAME: Murial Han
LICENSING EVALUATOR SIGNATURE:

DATE: 11/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/12/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 26-AS-20250804104755
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131
FACILITY NAME: STONE HAVEN CARE
FACILITY NUMBER: 435202428
VISIT DATE: 11/12/2025
NARRATIVE
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According to resident #4 (R4), resident #5 (R5), and resident #6 (R6) the facility has a no drug policy and they have never seen other residents using drugs or bring drugs into the facility.

The Department interviewed facility staff members and they reported that they were not aware of R1 using illegal drugs in the facility.

The Department made multiple attempts to interview R1 but it was unsuccessful as R1 was no a resident at the facility.

After the investigation, this allegation is unsubstantiated.

Regarding to the allegation of staff did not ensure sharp objects were inaccessible to residents in care- the reporting party stated that R1 repeatedly breaking rules of the facility and after an altercation, staff removed a knife from R1.

As part of the investigation, LPA interviewed staff member and the administrator.

The administrator denied the allegation and stated that facility locks all sharps at all times and the knife was purchased by R1 at the Supermarket nearby and it was confiscated when staff discovered it while cleaning R1's drawer. The administrator stated that facility staff is very careful not to search residents' rooms and their personal belongings due to personal rights. The administrator stated that R1 is no longer residing at the facility as other residents did not feel safe living in a same environment with R1.

LPA interviewed S1 and S2 and they stated that the facility locks all sharp objects at all times but residents go out every day and many of them go to the Lucky Supermarket nearby so it was difficult to know what they bring back. S2 stated that while he/she was cleaning R1's drawer, he/she found a knife and it was immediately confiscated and brought it to the administrator's office. S2 stated that R1 is no longer a resident at the facility.

During today's visit, LPA observed sharps were locked and inaccessible to residents in care.

After the investigation, this allegation is unsubstantiated.
SUPERVISORS NAME: Cara Smith
LICENSING EVALUATOR NAME: Murial Han
LICENSING EVALUATOR SIGNATURE:

DATE: 11/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/12/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 26-AS-20250804104755
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131
FACILITY NAME: STONE HAVEN CARE
FACILITY NUMBER: 435202428
VISIT DATE: 11/12/2025
NARRATIVE
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Regarding to the allegation of - staff do not ensure that resident hygiene needs are met, the reporting party stated that the facility needs shower regulation and logging. Many people aren't showering for months.

As part of the investigation, LPA interviewed the administrator, and staff.

LPA interviewed the administrator who denied the allegation and stated all the residents are independent and they are capable of taking showers by themselves. The administrator was not aware that there were residents not taking shower for months and stated that resident takes showers when they want to and staff encourages them to do so.

LPA interviewed S1 and S2 who stated that all the residents take their own shower and they were not aware of any residents who did not take a shower for months. S2 stated that there were a couple of residents who required assistance with turn on and off the water during their showers.

After the investigation, this allegation is deemed to be unsubstantiated.

Although the above investigations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is UNSUBSTANTIATED.
SUPERVISORS NAME: Cara Smith
LICENSING EVALUATOR NAME: Murial Han
LICENSING EVALUATOR SIGNATURE:

DATE: 11/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/12/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3