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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 435202428
Report Date: 08/16/2024
Date Signed: 08/16/2024 04:19:27 PM

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
07/18/2024 and conducted by Evaluator Simranjit Rai
COMPLAINT CONTROL NUMBER: 26-AS-20240718163229

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: 31DATE:
08/16/2024
UNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Lead Staff, Elizabeth Espique TIME COMPLETED:
04:30 PM
ALLEGATION(S):
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Residents are using drugs inside the facility due to lack of supervision.
Resident's personal belongings are being stolen because there are no locks on the doors of the residents room.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Simi Rai conducted an unannounced visit to conclude the complaint investigation. LPA Rai met with Lead Staff, Elizabeth Espique and stated the purpose of today’s visit. LPA Rai spoke with Administrator (ADM) Chidi Ikeme over the phone regarding the purpose of today's visit and received verbal consent for Lead Staff to review and sign today's report.

On 7/18/2024, the Department received a complaint with the above allegations. On 7/19/2024, the Department conducted an initial investigation at the facility.

Continuation on LIC 9099-C, Page 1 of 3.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Simranjit Rai
LICENSING EVALUATOR SIGNATURE:

DATE: 08/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 26-AS-20240718163229
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: 08/16/2024
NARRATIVE
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Page 2 of 3.
Residents are using drugs inside the facility due to lack of supervision.
It was alleged residents are using drugs inside the facility.

On 7/24/2024, the Department conducted an interview with resident (R1). R1 has not observed resident using drugs at the facility. R1 has not heard or seen anyone selling or distributing drugs at the facility. R1 stated if a resident returns to the facility inebriated and is not causing any issues, the facility staff will instruct the residents to go to their room and wait until the drugs wear off. R1 has heard of staff conducting surprise searches but never personally witnessed these searches.

On 7/24/2024, the Department conducted an interview with ADM. ADM stated the staff do not conduct random searched, but they conduct accidental searches where staff will find contraband and ask the resident to dispose the contraband in front of them. ADM stated the only type of drug found at the facility has been marijuana. ADM stated if the resident is under the influence, the staff will ask the resident to go to their room and staff will check on the resident every hour or hour and half. ADM stated staff have not reported seeing any residents selling or distributing drugs in the facility. ADM stated 1 resident has been reported doing drugs in the facility and resident is in the process of being evicted.

On 8/16/2024, LPA Rai conducted interviews with 13 residents. 6 Out of 13 residents refused to answer questions and 7 out of 13 residents spoke with LPA Rai. 7 Out of 7 residents stated they have not used drugs at the facility. 7 Out of 7 residents have not heard or seen residents using drugs at the facility.

On 8/16/2024, LPA Rai conducted interviews with 2 out of 2 staff at the facility (S1-S2). 2 Out of 2 staff stated they have not heard or seen residents use drugs at the facility. They stated the residents smoke cigarette in the designated smoking areas, but they have not seen other drugs being used by the residents at the facility. 2 Out of 2 staff stated they have not heard or seen residents using drugs at the facility.

Resident’s personal belongs are being stolen because there are no locks on the doors of the resident’s room.
It was alleged resident’s items are being stolen and keeps them at the office for safe keeping.
SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Simranjit Rai
LICENSING EVALUATOR SIGNATURE:

DATE: 08/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 26-AS-20240718163229
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: 08/16/2024
NARRATIVE
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Page 3 of 3.
On 7/24/2024, the Department conducted an interview with resident (R1). R1 stated R1 had concerns about residents coming into his/her room and stealing R1’s personal belongings and snacks. R1 started placing his personal items in the staff’s main office but R1’s snacks are still being stolen. Staff told R1 that they are not allowed to have any locks on the room doors.

On 7/24/2024, the Department conducted an interview with ADM. ADM stated Licensing prohibits locks and he offered R1 to place his/her valuables in the staff office if R1 was not going to be in the room.

On 8/16/2024, LPA Rai conducted interviews with 13 residents. 6 Out of 13 residents refused to answer questions and 7 out of 13 residents spoke with LPA Rai. 7 Out of 7 residents stated their personal belongs have not been stolen at the facility. 7 Out of 7 residents stated they have not heard or seen residents’ personal belongs are being stolen at the facility.

On 8/16/2024, LPA Rai conducted interviews with 2 out of 2 staff at the facility (S1-S2). 2 Out of 2 staff stated their personal belongs have not seen stolen at the facility. 2 Out of 2 residents stated they have not heard or seen resident’s personal belongs are being stolen at the facility. S1 stated resident R1 keeps he/her electronic items in the staff/office room while R1 is out of the facility for safekeeping. S1 stated R1 does not have an LIC 621 Client/Resident Personal Property and Valuables in the resident file. S1 stated they are not responsible for his electronic items, but they will keep the items safe that are place in the staff/office room.

On 8/16/2024, LPA Rai conducted interview with ADM. ADM stated the facility staff will report to the local law enforcement if they are aware if resident or residents are stealing at the facility. ADM stated incidents have occurred in the past and they have filed reports with the local law enforcement.

Based on the interviews conducted with clients and staff and based on observation and records review, although the allegations may have happened or are valid, there is not a preponderance of evidence to prove that the above allegations did or did not occur, therefore the allegations are UNSUBSTANTIATED.

No deficiencies were cited per California Code of Regulations, Title 22. This report was reviewed with Lead Staff, Elizabeth Espique and a copy of the report was provided.
SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Simranjit Rai
LICENSING EVALUATOR SIGNATURE:

DATE: 08/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2024
LIC9099 (FAS) - (06/04)
Page: 4 of 5