Senior Care Records.

Facility Evaluation Report

Haven's House of Assisted Living, Fairfield03/14/2023Licence 486804012

Capacity4
Census1
Date signed03/14/2023 02:58:43 PM
The inspector’s account

Licensing Program Analyst (LPA), Farhaan Sarangi arrived unannounced at Haven's House of Assisted Living for the purpose of conducting a Case Management-Deficiencies inspection that resulted from opening a complaint on March 14, 2023.

During the opening of the complaint on March 14, 2023 at approximately 01:00 PM, LPA was greeted at the door by Staff Member, Tyeka Miles who was not background cleared and associated to the facility (See LIC 809 dated for March 14, 2023). Administrator arrived 15 minutes later.

Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Appeal rights given. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in additional civil penalties. Civil Penally assessed. Exit interview was conducted, and a copy of this report was signed and given to the Licensee/Administrator.

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