Senior Care Records.

Facility Evaluation Report

Neema Haven Home, Martinez12/21/2023Licence 079200764

Capacity6
Census3
Date signed12/21/2023 12:21:45 PM
The inspector’s account

On 12/21/2023 Licensing Program Analyst (LPA) Lori Alexander arrived unannounced to conduct a Case Management visit. LPA met with Licensee/Administrator, Goodluck Ndefungo, and explained the purpose of the visit.

Back on 10/30/2023 during 1-Year Annual Required Inspection , LPA L. Alexander requested updated facility documents to be submitted by 11/06/2023. Administrator, Goodluck Ndefungo , failed to submit documents by requested due date. During emails LPA observed that the Administrator does not have current Liability Insurance. During today's visit Goodluck gave LPA L. Alexander a copy of the paid receipt for liability insurance. Goodluck will send a copy of the insurance policy to LPA L. Alexander once he receives the new insurance policy number.

In addition, during the annual inspection visit, LPA L. Alexander requested that the missing files for C1 and C3 be submitted. Administrator, Goodluck stated that C1 refuses to get TB, physical exam and sign required facility documents. Goodluck says that C3 has a case manager with the county that is currently working on scheduling an appointment for C3's physical exam.

The deficiencies were observed (see LIC809D) and cited from the California Code of Regulation, Title 22. Failure to correct the deficiencies may result in civil penalties.

Exit interview conducted. A copy of this report and appeal rights provided

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction