Rosewood Home

Allegation investigated: Illegal eviction

At 9:00am, Licensing Program Analyst (LPA), Angela Panushkina conducted an unannounced visit in response to the above-mentioned allegation. LPA met with the Administrator and explained the reason for the visit. At 9:05am, LPA requested resident and staff roster. At 9:10am, LPA requested copies of pertinent information which include, but not limited to Admission Agreement, Physician's Report, Appraisal Needs and Services Plan, Copy of an Eviction Letter, relevant to the investigation. At approximately 9:15am, LPA conducted a physical plant tour, to ensure health and safety of the residents are protected. Between 9:20am - 11:00am, LPA conducted an interview with the Administrator, three (3) staff, four (4) out of five (5) residents, who were able to communicate. Continue on LIC9099-C Substantiated Allegation: Illegal eviction The information obtained during investigation indicated that facility Administrator did issue a written 30-day notice to the R1/R1's Responsible Person. During the review of eviction notice, LPA observed that the eviction notice indicated the issue date of 10/22/2025 and pro-rated charges until 11/22/2025. However, the written notice did not include the reason for the eviction, a list of referral agencies, the right of the resident or resident’s legal representative to contact the department and the contact information for the local Long-Term Care Ombudsman nor did it include specific language in reference to the filing of an unlawful detainer as per SB 781 and 1569.683 H&S. In addition, Community Care Licensing Office was never notified or received a copy of the eviction notice since it was issued. Based on the information obtained during the investigation the allegation is Substantiated. Deficiency cited on LIC9099-D Exit interview conducted, appeal rights explained and copy of this report signed and delivered. Allegation: Staff do not ensure that facility is maintained in a sanitary manner It was alleged that R1 woke up in the middle of the night and there was urine on the bathroom floor. So, R1 set the box on top of it to prevent anyone from slipping and then waited in the kitchen for the staff to clean it up. To investigate this allegation LPA conducted an interview with the Administrator and was informed that on 09/20/25 R1 was prescribed a new medication and one of the side effects was “sleep disturbance”. The Administrator informed LPA that no urine was ever found on the floor and that the staff always make sure that the facility is clean. LPA conducted interviews with three (3) staff members, who corroborated the statement provided by the Administrator. Five (5) residents interviewed expressed no concern regarding this allegation. Additionally, R1 informed LPA that the staff is always keeping the facility clean and denied the above allegation. During today’s physical plant tour, LPA observed the kitchen, resident rooms, bathrooms and all common areas are clean and free from odor. Based on interviews and LPA observation, this allegation is deemed Unsubstantiated, at this time. Allegation: Licensee retaliated against resident The investigation included interviewing staff and residents. The Administrator and staff deny retaliating against any residents. LPA was informed that all residents are being treated with dignity and respect. Four (4) out of five (5) residents interviewed expressed no concern regarding this allegation. Therefore, based on interviews and information gathered during today’s visit, this allegation is deemed Unsubstantiated, at this time. No deficiency issued. Exit interview conducted and copy of this report signed and delivered.the state’s words, verbatim · CDSS document, Nov 6, 2025 · control 31-AS-20251031110552

From the deficiency page — Deficiency type: Type B · Section cited: HSC 1569.683(a)(2-4) · Plan of correction due date: Nov 6, 2025

Eviction notices... (a) In addition to complying with other applicable regulations... (2) Resources available to assist... (3) Information about the resident's right... (4) The following statement: "In order to evict a resident who..." This requirement is not met as evidenced by: Based on interviews and record reviews, licensee did not comply with the section cited above, by issuing an anlawful eviction letter to R1, without providing a reason which poses a potential health and safety risk to persons in care.the state’s words, verbatim · CDSS document, Nov 6, 2025

Plan of correction: On 11/03/2025, the Administrator rescind in writing the previously issued written 30 day notice of eviction. Should the administrator wish to proceed with eviction a new written letter of eviction will be served in compliance with Title 22 Regulations. POC is cleared during todays visit.

Type of visit: Required - 1 Year

At 8:30am, Licensing Program Analyst (LPA) Angela Panushkina arrived at the facility to conduct an unannounced annual inspection. Upon arrival, LPA met with the Administrator and LPA explained the reason for the visit. At 8:40am LPA conducted a tour of the physical plant and observed the following: The facility is licensed for capacity of six (6) residents. The fire clearance is approved for one (1) non-ambulatory in room #4 and two (2) non-ambulatory in room #5. The facility also has an approved hospice waivers for two (2). There are four (4) bedrooms designated for clients’ use, of which two (2) bedrooms are private, and two (2) bedrooms are shared. Bedrooms are appropriately furnished and have appropriate lighting. Live-in staff bedroom is located by the kitchen and kept locked at all times. Bathrooms have soap, paper towels and hand washing signs were observed. Extra towels and linens were readily available. The hot water temperature measured at 120.0°F. Facility maintains a temperature of 71°F. LPA observed there to be sufficient stock of one-week perishable foods and two-day non-perishable foods. Frozen foods are properly wrapped and stored appropriately. Food storage and preparation areas are clean and inaccessible to pests. There are two (2) fire extinguishers at the facility. One (1) is located by the kitchen and the second (2) fire extinguisher is located in the living room. Both extinguishers were last serviced on 05/29/2025. The laundry is located in the garage. The washer/dryer appears to be in good condition. Laundry supplies are kept inaccessible when not in use with supervision. All chemicals, detergents and medications are kept in the laundry room and inaccessible to residents in care. Smoke detectors and carbon monoxide monitors were tested at 9:30am and observed to be functional. At 9:40am, LPA observed appropriate outdoor furniture, with a covered shaded area for residents. Continue on LIC809-C LPA discussed the importance of maintaining care and supervision to meet the needs of residents. Between 10:00am to 11:00am, LPA reviewed records of four (4) residents and two (2) staff. Client and staff records appeared to be complete and updated. The annual fee is paid in full. LPA observed Administrator certificated renewed on 04/22/2024 with an expiration date of 04/22/2026. LPA collected the Certificate of Liability Insurance and LIC500. No citations were issued during this visit. Exit interview conducted and a copy of this report signed and delivered.the state’s words, verbatim · CDSS document, Jul 2, 2025

Type of visit: Required - 1 Year

At 09:30am Licensing Program Analyst (LPA), Angela Panushkina, conducted an unannounced annual inspection at the facility mentioned above. LPA was greeted by staff, who granted access to the facility and LPA explained the reason for the visit. At approximately, 09:35am physical tour was conducted with the staff and LPA observed the following: Kitchen: LPA toured the kitchen area and observed enough supplies of staple non-perishable for minimum 1 week and perishable for 2 days at the facility. All knives and sharps are observed to be locked in a kitchen cabinet and inaccessible to residents. Medications: At approximately, 09:40am LPA observed medications are centrally stored and locked in the kitchen cabinet and inaccessible to residents in care. Bedrooms: There are five (5) bedrooms designated for residents use and have sufficient lighting. All bedrooms are properly furnished, clean and have appropriate bedding and linens. Facility also has a staff room for live-in caregivers. Auditory alarms were tested and observed to be operational. Bathrooms: At 09:55am LPA observed all bathrooms are clean and in good repair. Properly supplied with toilet papers, soap and paper towels. The hot water temperature measured at 131.7°F. LPA observed appropriate grab bar and had non-skid mat. LPA observed appropriate hand washing signs posted in each bathroom. All trash cans in bathrooms had fitted lids to protect from cross contamination. Continue on LIC809-C Common Areas: The facility maintains a comfortable temperature at 77°F. The living room and dining area appeared clean and were properly furnished. No obstructions and or tripping hazards throughout the facility. There is a fire extinguisher by the kitchen and was last serviced on 03/28/2024. Outside areas: At approximately, 10:10am LPA toured the outside area of the facility. LPA observed appropriate outdoor furniture, with a covered shaded area for clients. LPA discussed the importance of maintaining the care and supervision to meet the needs of residents. There are no bodies of water. Smoke detectors/carbon monoxide. Smoke and carbon monoxide detectors were tested at 10:20am and observed to be operational. Administrative: LPA collected Certificate of Liability Insurance, Administrator Certificate and LIC.500. Deficiency issued on LIC809-D. Exit interview conducted. Copy of report signed and deliveredthe state’s words, verbatim · CDSS document, Jul 18, 2024

Allegation investigated: Staff did not assist residents with oral hygiene. Staff did not notice change in residents’ condition.

On 07/01/2024 at 11:15 am Licensing Program Analyst (LPA), Lorena Casillas conducted a subsequent unannounced complaint visit to investigate the above stated allegations. LPA met with Administrator Rosemarie Decenario and explained the reason for the visit. At 11:30 AM LPA Casillas conducted a physical plant tour. On 03/18/2024 LPA had previously requested resident roster, Liability Insurance, Bond, LIC 500 and copies of pertinent information relevant to the investigation including but not limited to resident records, and any other information pertaining to the investigation, therefore these items were not collected on this visit. Continued on LIC9099-C Unsubstantiated Allegation #1 Staff did not assist residents with oral hygiene. It is alleged that staff did not assist residents with oral hygiene. Regarding this allegation it is reported that Resident #1 (R1) was not assisted with maintaining oral hygiene. LPA interviewed the Administrator, and it was revealed that oral hygiene is performed on all residents that need assistance. Upon interviews with staff and residents it was revealed that not all residents require help, however when they are independent, staff constantly remind residents to self groom. When residents are not independent staff will perform grooming, including oral hygiene for them. Administrator and staff also stated that when residents need help, they are constantly helping with any needs that residents have. Furthermore, staff and Administrator were able to produce pictures of R1 and constant communication with R1’s family to show progress. Based on record review, interviews and observations, this allegation is Unsubstantiated at this time. Allegation #2 Staff did not notice change in residents’ condition. It is alleged that staff did not notice change in residents’ condition. Regarding this allegation it is reported that staff failed to recognize that R1 had Covid19. LPA interviewed the Administrator, and it was discovered that staff and residents had no symptoms of Covid or any flu like symptoms at the time when R1 was discovered by the hospital to have Covid 19. Administrator furnished temperature logs taken daily for residents where no spike in temperatures was recorded. Administrator also furnished resident medical updates where changes are constantly recorded however none of the changes recorded pertain to flu like or Covid symptoms. Furthermore, Administrator was able to provide LPA with proof of negative Covid 19 tests taken by all staff and all residents during the time that R1 was taken to the hospital also, Administrator provided proof of repeat negative Covid19 tests taken 48 hours after initial Covid19 test. Based on interviews, record reviews and observations this allegation is Unsubstantiated at this time. No citations issued. Copy of this report given to Administrator.the state’s words, verbatim · CDSS document, Jul 1, 2024 · control 31-AS-20240313093223