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Type of visit: Case Management - Licensee Initiated

On 09/24/26, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct a Case Management visit and met with Licensee Rosario Ramos. The purpose of this visit was to conduct a final walk through. Licensee has surrendered license. LPA and Licensee toured the facility and observed no sign of client residing in the facility and no staff present. All bedrooms and bathrooms were empty of client’s personal belongings. There was no indication of clients living in the facility. Forfeiture to be sent. The facility will be closed effective 09/24/26, pending Licensing Program Manager approval. Exit interview conducted. A copy of this report was provided to the Licensee whose, signature confirms receipt of report.the state’s words, verbatim · CDSS document, Sep 24, 2026

Type of visit: POC

On 07/14/26, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct a POC visit. LPA met Staff Adrian Sabroso. LPA spoke with Administrator Rosemarie Riemer via telephone during visit and discussed the POC. Licensee authorized staff to sign. LPA toured the facility. LPA observed the following: 1. Recording surveillance cameras was observed in the common areas. Staff access recording and LPA observed do audio. No deficiency issued during visit. An exit interview was conducted. A copy of this report was provided to Administrator via email as requested.the state’s words, verbatim · CDSS document, Jul 14, 2026

Allegation investigated: Staff handled resident in a rough manner. Staff yelled at resident.

On 07/08/26, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct initial complaint visit and deliver findings on the above allegations. LPA introduced self, stated the purpose of the visit, and met with Staff Teopista “Faye” Garcia Gasapos. Administrator (A1) Rosemarie Riemer and Licensee Rosario Ramos was called and arrived later during visit. During the course of the investigation, the department received evidence, conducted interviews, and toured the facility. During the course of the investigation, the department received video surveillance footage and conducted interviews. A1 yelled at R1 and pointed A1’s finger in R1’s face. As R1 was walking away A1 pulled R1’s shirt and hit R1 on the arm. Based on observation and interviews conducted, observation, and evidence received, the preponderance of evidence standard has been met, therefore, the above allegations are found to be SUBSTANTIATED. A deficiency is being cited on the attached Lic 9099D in accordance to California Code of Regulations, Title 22, Division 6. An exit interview was conducted. A copy of this report and appeal rights was provided to the Licensee whose signature on this report confirms receipt of this report. Substantiatedthe state’s words, verbatim · CDSS document, Jul 8, 2026 · control 24-AS-20260707082719

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87468.1(a)(1) · Plan of correction due date: Jul 9, 2026

87468.1 (a)(1) To be accorded dignity in their personal relationships with staff, residents, and other persons. This requirement is not met as evidenced by: Based on surveillance camera videos, A1 yelled at R1 and pointed A1’s finger in R1’s face. As R1 was walking away A1 pulled R1’s shirt and hit R1 on the arm, which poses/posed an immediate health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Jul 8, 2026

Plan of correction: Licensee and Administrator stated regulations will be reviewed. A written statement stating licensee have read, reviewed, and understood the personal rights regulations shall be submitted to Fresno CCL by 07/09/26.

Type of visit: Required - 1 Year

On 07/08/26, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct initial complaint visit and deliver findings on the above allegations. LPA introduced self, stated the purpose of the visit, and met with Staff Teopista “Faye” Garcia Gasapos. Administrator Rosemarie Riemer and Licensee Rosario Ramos was called and arrived later during visit. Two resident present during visit. Two residents arrived later during inspection. LPA toured facility with L1 and A1. All residents and sample of staff files were reviewed. Residents were observed in their bedrooms. The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside. Audio recording surveillance cameras were observed throughout the common areas. Emergency drills last completed on 06/30/26. Fire extinguisher was observed with a serviced date of 04/2026. Medications were observed kept locked in hall closet. Residents’ MARS was reviewed and medications were checked. 7 day supply of nonperishable and 2 day perishable food was observed. Freezer temperature maintained at 0 degrees F. Cleaning chemicals were observed locked under kitchen sink. Knives observed locked in the kitchen drawer. Nonperishable food and snacks observed locked in the garage. Expired nonperishable food was observed in the garage. Extra linens and bedding observed in hall closet. Residents' bedrooms were toured and observed to be adequately furnished with bed, dresser, and adequate lighting. Bathroom was toured and observed functionally. Non-skid mats and grabbed bars were observed in bathrooms.Hot water temperature was tested range between 107.9 degree F in hall bathroom and 107.5 degree F in master bathroom. Outside of facility toured. Side gate was self-closing and self-latching. Adequate outdoor seating is available for residents. Pool fence observed secure and locked. Carbon monoxide and smoke detectors were operational during inspection. A deficiency is being cited on the attached 809D in accordance to California Code of Regulations, Title 22, Division 6. An exit interview was conducted. The following documents are requested and submitted to Fresno CCL by: 7/14/26. The following updated forms were requested: Lic 308, Lic 500, Lic 610E, and current liability insurance. A copy of this report and appeal rights was provided to Licensee, whose signature on this form confirms receipt of this report.the state’s words, verbatim · CDSS document, Jul 8, 2026

Allegation investigated: Facility staff did not met resident's hygiene needs

On this date 01/12/26, Licensing Program Analyst (LPA) M. Yang conducted initial complaint investigation. LPA introduce self, stated the purpose of the visit, and met with Licensee (L1) Rosario Ramos. Licensee/Administrator (L2) Rosemaire Riemer was called and arrived later during inspection. LPA discussed the complaint and delivered complaint findings to Licensees. During the course of the investigation, the department conducted interviews and reviewed records. Records document the resident is constipated and has bowel impairment and able to perform the resident’s own activity daily living (ADL). Based on interviews conducted and records reviewed, allegation alleging staff did not met resident’s hygiene needs, the preponderance of evidence has not been met. Therefore, the above allegation is found to be UNSUBSTANTIATED. An exit interview was conducted. A copy of this report was provided to L2, whose signature on this form confirms receipt of this report. Unsubstantiatedthe state’s words, verbatim · CDSS document, Jan 12, 2026 · control 24-AS-20260107084508

Type of visit: Required - 1 Year

On 07/15/25, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct a required Annual Inspection. LPA introduced self, stated the purpose of the visit, and was greeted by caregiver Adrian Sabroso. Licensee Rosario Ramos was called and arrived shortly. Two residents were present during inspection. LPA toured facility with Licensee. Medication bottle was observed unlock in living room 2. Residents were observed in the common area. The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside. Emergency drill completed on 03/24/25. Fire extinguisher was observed with a serviced date of 7/30/24. Medications were observed kept locked in hall closet. Residents’ MARS was reviewed, and medications were checked. An adequate supply of perishable and non-perishable food was observed. Freezer temperature maintained at 26 degrees F and freezer at -6 degree F. Cleaning chemicals were observed locked under kitchen sink and in garage cabinet Extra linens observed. Residents' bedrooms were toured and observed to be adequately furnished with bed, dresser, and adequate lighting. Bathroom was toured and observed functional. Non-skid mat and grabbed bars were observed. Hot water temperature was tested range between 105.6 degree F in bathroom. Washer observed operational during visit. Outside of facility toured. Side gate was self-closing and self-latching. Adequate outdoor seatings available for residents. Pool fence observed secure and locked. Carbon monoxide and smoke detectors was operational during inspection. Sample of the residents’ and staff files were reviewed. A deficiency is being cited on the attached 809D in accordance to California Code of Regulations, Title 22, Division 6. An exit interview was conducted. The following documents are requested and submitted to Fresno CCL by: 7/21/25. The following updated forms were requested: Lic 308, Lic 500, Lic 610E, current liability insurance, and current Administrator Certificate. A copy of this report and appeal rights was provided to Licensee, whose signature on this form confirms receipt of these report.the state’s words, verbatim · CDSS document, Jul 15, 2025

Type of visit: Case Management - Annual Continuation

On 08/15/24, Licensing Program Analyst (LPA) M. Yang arrived at the facility unannounced to conduct a continuation of the Required Annual Inspection. LPA met with staff Teopista “Fay” Gasapos. Licensee/ Administrator Rosemarie Riemer was called and arrived later during inspection. All staff files were reviewed. Staff working on shift during inspection did not have current CPR certification. A deficiency is being cited on the attached 809D in accordance to California Code of Regulations, Title 22, Division 6. An exit interview was conducted. Plan of correction was discussed with Licensee/ Administrator. The following documents are requested and submitted to Fresno CCL by: 8/21/24. The following updated forms were requested: Lic 308, Lic 500, Lic 610E, current liability insurance, and current Administrator Certificate. A copy of this report and appeal rights was provided to Licensee/Administrator, whose signature on this form confirms receipt of these report.the state’s words, verbatim · CDSS document, Aug 15, 2024

Type of visit: Required - 1 Year

On 08/09/24 Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct a required Annual Inspection. LPA introduced self, stated the purpose of the visit, and was greet by House manager Renee Gonzalez. Administrator Rosemarie Riemer was called and stated unable to attend meeting. Administrator authorized House manager to sign report. Two residents were present during inspection. Four residents arrived later during inspection. LPA toured facility with staff. Residents were observed in the common area. The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside. Medications were observed kept locked in kitchen shelves. Residents’ MARS was reviewed, and medication were audit. An adequate supply of perishable and non-perishable food was observed. Cleaning chemicals was observed stored and under kitchen sink unlock. Fire extinguisher was observed with a serviced date of 7/30/24. Extra linens observed. Residents' bedrooms were toured and observed to be adequately furnished with bed, dresser, and adequate lighting. Bathroom are toured and observed functional. Non-skid mat and grabbed bars were observed. Hot water temperature was tested range between 108.8 in bathroom. Outside of facility toured. Side gate was self-closing and self-latching. Outside was observed with adequate outdoor seatings available for residents. Pool fence observed secure and locked. Carbon monoxide and smoke detector operating during inspection. Half of the residents’ file were reviewed. Due to time constraints, staff files will be reviewed at a later date. A deficiency and an immediate Civil Penalty of $500 was assessed. See Lic 421BG is being cited on the attached Lic 809D in accordance to California Code of Regulations, Title 22, Division 6 see attached Lic 809D. Exit Interview conducted. A copy of this report and appeal rights was emailed to Administrator.the state’s words, verbatim · CDSS document, Aug 9, 2024

The state marks this report as 3 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.