Inspection Reports for Safe Haven – Brentwood I
960 Griffith Lane, Brentwood, CA 94513, CA, 94513
Back to Facility ProfileInspection Report Summary
Most inspections before licensing showed no deficiencies, indicating the facility met initial requirements well. However, the most recent inspection on January 22, 2025, found multiple deficiencies including staff lacking required fingerprint clearance and health screenings, unsafe placement of a non-ambulatory resident, unlocked hazardous cleaning supplies, and missing doctor orders for bed rails. A $500 civil penalty was issued for the fingerprint clearance violation. These issues mainly involved staff compliance, resident safety, and environmental hazards. There is a clear decline in compliance compared to earlier clean reports.
Deficiencies per Year
8
6
4
2
0
High
Moderate
Census Over Time
Census
Capacity
Inspection Report
Annual Inspection
Census: 3
Capacity: 6
Deficiencies: 5
Jan 22, 2025
Visit Reason
An unannounced 1-Year Required inspection was conducted to evaluate compliance with licensing regulations and facility safety standards.
Findings
The inspection found multiple deficiencies including staff not having required health screenings and fingerprint clearance, a non-ambulatory resident placed in an ambulatory room, unlocked hazardous cleaning supplies, and lack of doctor orders for half bed rails. A civil penalty of $500 was assessed for staff fingerprint clearance violation.
Severity Breakdown
Type A: 3
Type B: 2
Deficiencies (5)
| Description | Severity |
|---|---|
| Staff member S3 was not fingerprint cleared and not associated with the facility, posing an immediate health and safety risk. | Type A |
| Resident R2, who is non-ambulatory, was placed in an ambulatory room, posing an immediate health and safety risk. | Type A |
| Cleaning supplies including pledge multi surface spray, gorilla spray adhesive, Lysol sanitizer spray, and others were found in an unlocked cabinet under the kitchen sink, posing an immediate health, safety or personal rights risk. | Type A |
| Residents R1, R2, and R3 had half bed rails without doctor orders, posing a potential health, safety or personal rights risk. | Type B |
| Staff members S2 and S3 were missing health screenings in personnel files, posing a potential health and safety rights risk. | Type B |
Report Facts
Civil penalty amount: 500
Deficiency count: 5
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jose Eden De la Cruz | Care Staff | Met with Licensing Program Analyst during inspection and involved in facility tour. |
| Aileen Poquiz | Administrator | Agreed to corrective actions including fingerprint clearance and moving resident rooms. |
| Tonica Syess-Gibson | Licensing Program Analyst | Conducted the inspection and authored the report. |
| Harpreet Humpal | Licensing Program Manager | Supervisor overseeing the inspection. |
Inspection Report
Original Licensing
Capacity: 6
Deficiencies: 0
Jan 16, 2024
Visit Reason
The inspection was conducted as a prelicensing visit to evaluate the facility for initial licensing.
Findings
The Licensing Program Analysts completed the prelicensing inspection of the facility inside and outside, including COMP III training. The pre-licensing process was completed with no deficiencies noted.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Aileen Poquiz | Administrator | Met with Licensing Program Analysts during prelicensing inspection |
| Ramandeep Sidhu | Met with Licensing Program Analysts during prelicensing inspection | |
| James Sampair | Licensing Program Analyst | Conducted prelicensing inspection |
| Bennett Fong | Licensing Program Manager | Named in report header |
Inspection Report
Original Licensing
Capacity: 6
Deficiencies: 0
Dec 28, 2023
Visit Reason
The visit was an initial licensing evaluation conducted virtually to verify the applicant/administrator's understanding of community care facility licensing laws and readiness for licensure.
Findings
The applicant/administrator demonstrated understanding of facility operation, admission policies, staffing requirements, restrictive health conditions, general provisions, emergency preparedness, complaints and reporting, and pre-licensing readiness. Identification and documentation were verified.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Aileen Poquiz | Administrator/Licensee | Applicant/administrator who participated in the licensing evaluation and interview. |
| Darla Neeley | Licensing Program Manager | Named as Licensing Program Manager overseeing the evaluation. |
| Ahmad Reshad | Licensing Program Analyst | Named as Licensing Program Analyst conducting the evaluation. |
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