Roses Resthome

Allegation investigated: Staff do not ensure facility is free of bed bugs

At approximately 8:55AM, Licensing Program Analyst (LPA) Felias, arrived unannounced to deliver findings for a complaint investigation regarding the above allegation and met with Licensee, Silvana Daniel. During the course of the investigation, the Department requested and reviewed documents, conducted interviews, and made observations. The following allegation was investigated, “Staff do not ensure facility is free of bed bugs.” Complaint alleged that Resident 1 (R1) has bed bugs and that it has been an ongoing problem at the facility for at least 6 months. Per complaint, the facility has only treated R1’s room and no other rooms in the facility. Complaint also stated that R1 was going to be evicted because the facility didn’t have issues with bed bugs until R1 moved to the facility. Continued on LIC9099C Unsubstantiated Continued from LIC9099 Interview conducted with Licensee stated that R1 goes to a center multiple times a week and that it’s unknown how R1 got bed bugs. Per Licensee, once it was discovered that bed bugs were in R1’s room, they replaced R1’s mattress, bedframe, and boxspring and contacted a pest control company to help with treatment. Per Licensee, the company has visited the home and treated R1’s room three times. Currently R1 has been changing their clothes every day when they return home from the center. Licensee also stated that they know that the bed bugs have not spread to other areas of the facility because they change the bedding daily and launder and dry all the linens on high heat. Licensee also stated that they had a conversation with R1’s guardian about what to do about the bed bugs and brought up the possibility of eviction but did not issue R1 an eviction notice. It was observed that a formal eviction notice has not been issued for R1. Interview with Staff Member 1 (S1) stated that they believe that the bed bugs could have come from the center R1 attends every day. Per S1, R1’s room has been treated for bed bugs at least three times with chemical steam treatment and that R1’s furniture was replaced. S1 stated that they know bed bugs haven’t spread to other parts of the facility because they change all the residents’ bedding, wash and dry all the linens on high heat, and they haven’t observed any evidence of bed bugs on the linens or bed bug bites on the residents. Review of facility documents showed that the facility has had R1’s room treated on 11/20/2025, 01/30/2026, and 03/26/2026. Review of documentation for 03/26/2026 visit indicated that the pest control company would conduct a follow up visit/service. Based on document review, interviews conducted, and observations made, this allegation is Unsubstantiated. A finding that the complaint allegation is Unsubstantiated means that although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. No Deficiencies Cited during visit. Exit interview conducted. Copy of report discussed and provided to Licensee. Signature on form confirms receipt of documents.the state’s words, verbatim · CDSS document, Apr 30, 2026 · control 21-AS-20260401140056

Type of visit: Required - 1 Year

At approximately 12:10PM, Licensing Program Analyst (LPA) Felias arrived unannounced to conduct a 1-Year Required Visit and met with Staff Members, Elma Cordero and Elijha Cintron. Licensee/Administrator, Silvana Daniel arrived at approximately 12:20PM. Facility serves residents with dementia and has a plan of operation for dementia care and programming on file. Facility has an approved fire clearance and capacity for 8 non-ambulatory residents. Facility has an approved hospice waiver for 6 individuals. Upon arrival, LPA was informed that there were 7 Residents in care and 2 staff members on-site. At approximately 12:15PM, LPA reviewed the Facility's Staff Roster and found that all staff on-site were background cleared and associated to the facility per regulation. LPA conducted a walk-though of the facility with Licensee/Administrator and observed the following: facility was found to be clean and at a comfortable temperature with all exits free from obstruction. Facility had emergency lighting. Facility is a 1 story building with 7 Resident bedrooms, 1 staff bedroom, 4 bathrooms, and common spaces. Facility has an Infection Control plan on file. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. LPA observed instances of unlabelled or expired foods in facility fridge. There was an appropriate supply of cleaning products, linens, hygiene products and paper products available for residents. Mattress pads were in place or available for Resident use. Bathrooms were equipped with necessary grab bars, and non-slip floors/mats were present. Facility's cleaning supplies and laundry detergent were observed to be accessible during visit in laundry room. It was observed that facility has a cabinet for cleaning supplies but it was unlocked with the key attached during visit. Facility's fire extinguishers was last inspected November 2025. Facility's last emergency/disaster drill was conducted January 2026. Facility's emergency disaster plan was last reviewed and updated on 03/01/2026. LPA reviewed 2 staff files and 4 resident files. LPA also reviewed resident medication. Staff files had current First Aid/CPR Continued on LIC809 Continued from LIC809 certification. Review of Staff Member 1's (S1) file was found to be missing proof of health screening. Review of last year's annual visit indicated that S1 did have a health screening on file but Licensee was unable to locate it during this year's annual visit. Review of Staff Member 2's file (S2) was found to be missing proof of their initial 40 hours of training. 1 of 4 resident files were found to be missing an updated needs/services plan. It was observed that another resident is considered bedridden per their medical assessment. Further review showed that this resident is receiving hospice services and facility sent notification to the Marin Fire Department. Facility to clarify fire clearance with Marin Fire Department and to submit an updated facility sketch to Community Care Licensing by 04/03/2026. LPA conducted review of resident medication. LPA observed that resident central storage logs were not documented correctly and had errors such as missing quantity of medication, incorrect dosage, incorrect expiration and fill dates, and not writing out the complete medication instructions. LPA also observed that medications were being prepoured in advance. LPA observed that 5PM medications were poured for a resident. Per Licensee, the medication had been poured that day around 11AM. LPA and Licensee discussed filling out the Centrally Storage Log (LIC622) accurately and live medication pouring expectations. Administrator's Certificate for Licensee, Silvana Daniel, (7036051740) was current with an expiration date of 03/21/2027. LPA is requesting the following documents to update facility file: LIC308 – Designation of Facility Responsibility LIC500 - Personnel Report LIC610E - Emergency Disaster Plan Updated Liability Insurance Documents to be submitted to Community Care Licensing by 04/24/2026. Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. Exit interview conducted. Copy of report, LIC-809D, Plan of Corrections, and Appeal Rights discussed and provided to Licensee. Signature on form confirms receipt of documents.the state’s words, verbatim · CDSS document, Mar 24, 2026

The state marks this report as 8 pages; the online copy we transcribed has 7. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

At approximately 09:30AM, Licensing Program Analyst (LPA) Ali Deniz and Licensing Program Manager (LPM) Victoria Bertozzi arrived unannounced to conduct a 1-Year Required Visit and met with Staff Member, Elma Cordero. Licensee/Administrator, Silvana Daniel arrived shortly during the visit. Facility serves residents with dementia and has a plan of operation for dementia care and programming on file. Facility has an approved fire clearance and capacity for 8 non-ambulatory residents. Facility has an approved hospice waiver for 6 individuals. Upon arrival, LPA was informed that there were 4 Residents in care and 1 staff member on-site. At approximately 9:45AM, LPA/Administrator toured the building and did following observations; grounds which was found to be clean and in good repair. Facility had emergency lighting. Facility is a 1 story building with 7 Resident bedrooms, 1 staff bedroom, 4 bathrooms, and common spaces. Facility has an Infection Control plan on file. 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. During walk-though LPA/Administrator observed cleaning supplies were accessible to residents in kitchen cabinet under the sink was unlocked and containing cleaning supply. Also, cabinet in the laundry room were containing cleaning supply and lock weren't properly functioning(Citation given). Licensee agrees to remove the cleaning supply under the sink to the laundry cabinet and fix the lock. The facility has a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. Facility kitchen, refrigerators and freezers were clean, and food was stored per regulation. Bathrooms were equipped with necessary grab bars, and non-slip floors/mats were present. Continued on LIC809C... Continued from LIC809C Water temperature measured 114.2 degrees F which is within regulation between 105- and 120-degrees F at faucets accessible to residents. Fire extinguishers inspected and charged/last inspected 11/01/2024. Carbon Monoxide detectors were present. Medication is centrally stored and secure. At approximately 11:10AM, LPAs reviewed 4 resident files and all found to be in order and have updated documents on file. Medication records are contained physician's orders for each resident per regulation. Hospice care plans were up to date for each hospice resident. At approximately 11:45AM, LPAs reviewed 2 staff records. LPA observed 1 out of 2 staff files did not have the health screening completed as required by the Health and Safety Code (Citation given). Facility has supplies enough to operate for more than 72 hours in an emergency. Facility conducted and documented a disaster drill on 01/20/2025. Updated copies of the following documents were requested for facility file and are to be submitted to CCL within 30 days of this visit: LIC308 – Designation of Facility Responsibility LIC500 - Personnel Report LIC610E - Emergency Disaster Plan Evidence of Updated Liability Insurance Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. Exit interview conducted. Copy of report, LIC-809D, Plan of Corrections, and Appeal Rights discussed and provided to Administrator. Signature on form confirms receipt of documents.the state’s words, verbatim · CDSS document, Mar 7, 2025

Type of visit: Case Management - Annual Continuation

At approximately 11:45AM, Licensing Program Analyst (LPA) Felias arrived unannounced to continue a Required 1 Year visit and met with Staff Member, Sally Menke, and Licensee, Silvana Daniel. Upon arrival, LPA was informed that there were 6 residents in care and one staff member on-site. At approximately 12:00PM, LPA reviewed the Facility's Staff Roster and found that all staff on-site were background cleared and associated to the facility per regulation. LPA reviewed staff and resident files and resident medication. Resident files were all found to be well organized, thorough and contained the required documentation. Staff files had current First Aid and CPR certification. LPA observed that staff members had 2022 annual training, but were missing 2023 annual training per Health and Safety Code (this deficiency has been cited, see LIC809D, Health and Safety Code 1569.625(b)(2)). Medication was observed to be centrally stored and secure. Administrator's Certificate for Licensee Silvana Daniel (6003231740) was current with an expiration date of 03/21/2025. LPA requested the following documents to update facility file: Designation of Facility Responsibility (LIC 308) Emergency Disaster Plan (LIC 610D) Updated Personnel Report (LIC 500) Register of Clients/Residents (LIC 9020) Updated Liability Insurance Documents to be submitted to Community Care Licensing (CCL) by due date of 05/16/2024. Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. Exit interview conducted. Plan of Corrections reviewed and developed with Licensee. Copy of report, LIC809D, and Appeal Rights discussed and provided to Licensee. Signature on form confirms receipt of documents.the state’s words, verbatim · CDSS document, Apr 16, 2024

Type of visit: Required - 1 Year

At approximately 1:20PM, Licensing Program Analysts (LPAs) Felias and Florio arrived unannounced to conduct a 1-Year Required Visit and met with Staff Member, Elma Cordero. Licensee/Administrator, Silvana Daniel arrived during visit at approximately 1:30PM. Facility serves residents with dementia and has a plan of operation for dementia care and programming on file. Facility has an approved fire clearance and capacity for 8 non-ambulatory residents. Facility has an approved hospice waiver for 6 individuals. Upon arrival, LPA was informed that there were 5 Residents in care and 2 staff members on-site. At approximately 1:45PM, LPAs reviewed the Facility's Staff Roster and found that all staff on-site were background cleared and associated to the facility per regulation. At approximately 1:50PM, LPAs conducted a walk-though of the facility with Licensee/Administrator. LPAs observed the following: The facility was found to be clean and at a comfortable temperature with all exits free from obstruction. Facility had emergency lighting. Facility is a 1 story building with 7 Resident bedrooms, 1 staff bedroom, 4 bathrooms, and common spaces. Facility has an Infection Control plan on file. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. There was an appropriate supply of cleaning products, linens, hygiene products and paper products available for residents. Mattress pads were in place or available for Resident use. Toxins were observed to be stored inaccessible to residents. Bathrooms were equipped with necessary grab bars, and non-slip floors/mats were present. Facility's fire extinguishers was last inspected November 2023. Facility's last fire drill was conducted January 2024. LPAs unable to complete Annual Inspection. Annual Continuation Visit to be conducted at a later date. Exit interview conducted. Copy of report discussed and provided to Licensee. Signature on form confirms receipt of documents.the state’s words, verbatim · CDSS document, Mar 26, 2024