<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 435202428
Report Date: 10/30/2025
Date Signed: 03/04/2026 02:07:52 PM

Substantiated


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
10/27/2025 and conducted by Evaluator John Calandra
PUBLIC
COMPLAINT CONTROL NUMBER: 26-AS-20251027233036
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:
10/30/2025
UNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Lorraine Baca, Co-Administrator and Elizabeth Elisque, Co-AdministratorTIME COMPLETED:
01:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not keep the facility free from bedbugs
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
***************************************This is an Amended Report*******************************************************

On 10/30/2025, Licensing Program Analyst(LPA) John Calandra arrived at the facility to open this complaint investigation. LPA Calandra was greeted by Bernadita Pagusara, Caregiver and explained the purpose of the visit. Chidi "Goddy" Ikeme, Administrator/Licensee and Lorraine Baca, Administrative Assistant arrived later during the visit.

Complaint alleged that staff did not keep the facility free from bed bugs. On 10/30/2025, LPA Calandra spoke to the Administrator/Licensee and learned that they were aware R1 had bed bugs in their room. Although the facility has contracted with a pest control company to treat for bed bugs, R1 did not allow the pest control company into their room for the treatment. The report that treatment did not occur was communicated to the facility on the monthly pest control report.

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Andrea Medlin
LICENSING EVALUATOR NAME: John Calandra
LICENSING EVALUATOR SIGNATURE:

DATE: 03/04/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2026
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 2
Control Number 26-AS-20251027233036
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: 10/30/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
**************************************************This is an Amended Report**********************************************

Based on the LPA’s observations and interviews, the preponderance of evidence standard has been met. Therefore, the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 6, are being cited on the attached LIC809-D.

An exit interview was conducted. A copy of the report along with Appeal Rights were provided to the facility representative.
SUPERVISORS NAME: Andrea Medlin
LICENSING EVALUATOR NAME: John Calandra
LICENSING EVALUATOR SIGNATURE:

DATE: 03/04/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2