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Inspection visit

complaint

HAVEN HOUSE OF SAN RAFAELLicense 216803931
Clean visit · 0 citations

Inspector’s narrative

What the inspector wrote

Continued from LIC9099 second half bed rail and the gait belt as a safety precaution for R1. Per interviews, the gait belt is used as a safety precaution for R1 when staff are doing other tasks such as cooking or providing care to other residents. LPA was informed that the video camera has no audio and was placed as an additional safety precaution to notify Night Shift staff when R1 gets up at night. Interviews further revealed that R1's family was verbally notified of the camera/video monitoring. Interview conducted with R1 revealed that they preferred to go to bed at 10:00PM but usually get put into bed at 9PM. Per R1, they are unable to get out of bed on their own due to their recent injury and would require assistance to leave. LPA conducted a walkthrough of the facility and observed the following: R1's bed had two half bed rails creating a full bed rail (picture taken). LPA also observed that R1 had a white gait belt around their wheelchair. Review of R1's file showed that they are not receiving hospice services at this time and do not have a physician's order for use of bed rails or for use of a gait belt. There is also no documentation in the file regarding camera/video monitoring for R1's room. Based on record review, interviews conducted, and observations made, these allegations are Substantiated . A finding that the complaint allegation is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met. Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiencies, on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. Exit interview conducted. Copy of report, LIC9099D (Deficiency Page), Plan of Corrections, and Appeal Rights discussed and provided to Licensee. Signature on form confirms receipt of documents.

Citations

No citations recorded on this visit

The inspector found no violations of California child care regulations during this visit.

FAQ · About this visit

Common questions about this visit

What happened during the August 1, 2025 inspection of HAVEN HOUSE OF SAN RAFAEL?

This was a complaint inspection of HAVEN HOUSE OF SAN RAFAEL on August 1, 2025. The inspection found no deficiencies and no citations were issued.

Were any citations issued to HAVEN HOUSE OF SAN RAFAEL on August 1, 2025?

No citations were issued during this inspection. The facility was found to be in compliance with all applicable regulations.

What type of inspection was this?

This was a complaint inspection. Complaint inspections are triggered when someone reports a concern about the facility to CCLD.

SourceView on CCLDView original report

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Data from CCLD public records. Last updated . If you believe any information is inaccurate, report it here.