Roseland Care Home

Type of visit: Required - 1 Year

At approximately 11:00AM, Licensing Program Analyst (LPA) Chris Arnhold made an unannounced annual required inspection of this licensed senior care facility. LPA met with staff Kaliece Diaz. Licensee Kiko Smith arrived later. At approximately 11:15AM, LPA toured the building and grounds which was found to be clean and in good repair. LPA observed all walkways and exits to be unobstructed. All notices that are required to be posted have been posted and are in a highly visible area. LPA observed activity supplies for resident use. The amount of fresh and nonperishable foods is within regulation. Facility kitchen, refrigerators and freezers were clean, and food was stored properly. Toxins are stored and not accessible. Water temperature measured below regulation at faucets accessible to residents. Hot water heater was adjusted during visit and retested at the conclusion of the visit and was within regulation. Fire extinguishers inspected were charged. Smoke detectors were found to be in working order. Carbon Monoxide detectors were present. There was enough lighting in all common areas, resident rooms, and hallways. Medication is centrally stored and secure. At approximately 11:45AM, LPA reviewed 4 resident records and 4 staff records. LPA found resident records contained current and signed admission agreements, physician reports and physician orders. Resident appraisals were current. Medication records are thorough and contained physician's orders for each resident. Evidence of current required annual training and first aid and CPR training were current in staff files reviewed. At approximately 12:45PM, LPA reviewed the facility emergency disaster plan. Facility has a generator to supply power during an outage. The plan outlines evacuation routes, which are shown on facility sketch and has alternative meeting locations. Facility has supplies enough to operate for more than 72 hours in an emergency. Facility conducts and documents emergency drills monthly. LPA received updated liability insurance documentation. No citations issued during this visit.the state’s words, verbatim · CDSS document, Jul 28, 2026

Type of visit: Required - 1 Year

At approximately 11:00AM, Licensing Program Analyst (LPA) Chris Arnhold made an unannounced annual required inspection of this licensed senior care facility. LPA met with Licensee Kiko Smith. At approximately 11:15AM, LPA toured the building and grounds which was found to be clean and in good repair. LPA observed all walkways and exits to be unobstructed. All notices that are required to be posted have been posted and are in a highly visible area. LPA observed activity supplies for resident use. The amount of fresh and nonperishable foods is within regulation. Facility kitchen, refrigerators and freezers were clean, and food was stored properly. Toxins are stored and not accessible. Water temperature measured within regulation between 105 and 120 degrees F at faucets accessible to residents. Fire extinguishers inspected were charged. Smoke detectors were found to be in working order. Carbon Monoxide detectors were present. There was enough lighting in all common areas, resident rooms, and hallways. Medication is centrally stored and secure. At approximately 11:45AM, LPA reviewed 4 resident records and 4 staff records. LPA found resident records contained current and signed admission agreements, physician reports and physician orders. Resident appraisals were just out of date. Medication records are thorough and contained physician's orders for each resident. Evidence of current required annual and first aid and CPR training were current in staff files reviewed. At approximately 12:45PM, LPA reviewed the facility emergency disaster plan. Facility has a generator to supply power during an outage. The plan outlines evacuation routes, which are shown on facility sketch and has alternative meeting locations. Facility has supplies enough to operate for more than 72 hours in an emergency. Facility conducts and documents emergency drills quarterly.. LPA received updated liability insurance documentation. No citations issued during this visit.the state’s words, verbatim · CDSS document, May 20, 2025

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.

Type of visit: Office

Facility Type: RCFE Application Type: CHOW EAO Capacity: 4 Census (if any clients in care): COMP II Participants: CLEO SMITH/ADMINISTRATOR AND APPLICANT Interview Method: Telephone interview On 8/9/24, applicant/administrator participated in COMP II. Identification of the applicant and administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant and administrator confirmed that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Admission Policies 3. Staffing requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, Aug 9, 2024

Type of visit: Prelicensing

At approximately 8:20AM, Licensing Program Analyst (LPA) Chris Arnhold arrived at this facility unannounced to conduct a pre-licensing inspection. LPA met with Administrator Cleo Smith and explained the purpose of the visit. Administrator certificate is current. LPA toured the facility to ensure the health and safety of residents in care. Areas toured include but are not limited to resident rooms, common areas, bathrooms, kitchen, storage areas and back yard. In the areas toured no immediate health, safety, or personal rights violations were observed. Staff and resident records are secure. First Aid/CPR certification was current. The common areas, bathrooms and kitchen were clean and in good repair. All bedrooms had required furniture, bedding, and lighting. Cooking/dining equipment and utensils were present. Food appears to be stored and prepared properly. Facility has required seven-day non-perishable and two day perishable supply of food. Medication is locked and not accessible. The facility was observed to be at a comfortable temperature. First aid kit was present. Fire extinguishers were fully charged. Smoke detectors are all operational. Carbon Monoxide Detector was present. All employees requiring background checks are cleared. No pools/bodies of water are on the premises. Facility conducts emergency drills quarterly. LPA received evidence of Liability insurance at the time of visit. Component III orientation was conducted at facility. Applicant conveyed a good knowledge of Title 22 regulations. LPA will submit the application packet for a final review and approval from the Licensing Program Manager.the state’s words, verbatim · CDSS document, Jul 16, 2024