Fullerton Rosewood Assisted Living

Allegation investigated: Resident's personal rights were violated

Licensing Program Analyst (LPA) Samer Haddadin conducted an unannounced visit to the facility to deliver findings regarding the above-mentioned allegation. Upon arrival, LPA Haddadin was met by Office Assistant Jin Pak, who granted entry into the facility. LPA explained the purpose of the visit. Administrator Jane Kim was notified via phone and advised of the visit.. The Department received a complaint alleging that “Resident’s personal rights were violated.” During the investigation, LPA conducted interviews with Resident 1 (R1), facility staff, residents, and the responsible party. LPA also reviewed R1’s file and facility records, including the Release of Client/Resident Medical Information form, Consent for Emergency Medical Treatment, Adult and Elderly Residential Facilities form signed by the responsible party, Physician’s Report, Resident Appraisal, and Admission Agreement. {***CONTINUE 9099C***} Unsubstantiatedthe state’s words, verbatim · CDSS document, Jun 2, 2026 · control 22-AS-20260306135751

Allegation investigated: Staff did not address an ongoing conflict between residents Staff did not treat resident with dignity or respect

Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced complaint visit to initiate an investigation into the above allegations. LPA was greeted and granted entry into the facility and explained the reason for the visit. During the course of the investigation, LPA toured the facility and interviewed staff and residents as well as reviewed and obtained pertinent documentation such as eviction notice. Regarding the allegations that staff did not address an ongoing conflict between residents and staff did not treat resident with dignity or respect, the investigation revealed the following: Incident dated 01/27/2026 reported to licensing indicated that Resident 1 (R1) threatened R2 verbally and raised the resident's walker at R2. 911 was called by R2's family member as R1 was escalating. There were no injuries between the two residents and police talked to both parties involved. Administrator indicates a long history of issues between the two residents instigated by R1. R1the state’s words, verbatim · CDSS document, Feb 25, 2026 · control 22-AS-20260217201628

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Allegation investigated: Staff did not keep resident's informaiton confidential.

Licensing Program Analyst (LPA) Jenifer Tirre conducted an unannounced visit on an investigation competed by the Department. LPA Tirre was greeted and granted entry by staff and explained reason for visit. LPA met with Administrator Jane Kim. During the course of investigation, the Department conducted interviews and reviewed documents. The investigation conducted revealed the following: On January 2, 2026 the department received a complaint alleging that staff did not keep residents’ information confidential. Department conducted interviews with staff, residents and witness. Interviews with staff revealed that five Five of five staff state that they have not witnessed other staff giving out personal information of residents. Three of five staff stated they contact either Physician or responsible parties if additional medical information is to be obtained on behalf of residents care such as updated medication lists, clarification of Doctors orders, discharge paperwork, change of conditthe state’s words, verbatim · CDSS document, Jan 8, 2026 · control 22-AS-20260102163909

Allegation investigated: Staff yelled at a resident in care. Staff illegally evicted a resident in care.

Licensing Program Analyst (LPA) Fred Arias conducted an unannounced complaint visit to initiate an investigation into the above allegations. LPA was greeted and granted entry into the facility and explained the reason for the visit. It was alleged staff yelled at resident in care and staff illegally evicted a resident in care. During the investigation, LPA conducted interviews with residents in care and staff. LPA reviewed records obtained. The investigation determined as follows: Regarding the allegation staff yelled at resident in care, it was reported Administrator (AD) Jane Kim was yelling and humiliating Resident 1 (R1). LPA interview with R1 stated AD yelled at them most recently on October 22, 2025 but cannot articulate the details of the incident or recall which staff or residents witnessed the incident. Interviews with five out of five remaining residents stated they have never been yelled at by staff and have not witnessed staff yell at other residents. Unfoundedthe state’s words, verbatim · CDSS document, Jan 2, 2026 · control 22-AS-20251224150848

Allegation investigated: Due to lack of supervision, resident physically assaulted another resident

Licensing Program Analyst (LPA) Ruth Martinez visited the facility to deliver findings for the investigation into the above identified complaint allegations. LPA arrived at the facility was greeted and granted entry by staff. LPA spoke with Jane Kim, Administrator, and explained the purpose of the visit. Findings are based upon this investigation which included tour of the physical plant of the facility, resident/facility file review, and interviews conducted. It is alleged due to lack of supervision resident physically assaulted another resident. Record review reflects that at the time of visit census was 54 residents and staff roster reflect there is three shifts AM, PM, and NOC with 2-4 carestaff assigned per shift. An unusual incident report LIC621 received on July 10, 2025, resident Continued on LIC9099-C Unsubstantiatedthe state’s words, verbatim · CDSS document, Jul 24, 2025 · control 22-AS-20250711095927

Allegation investigated: Staff did not maintain facility floors free of debris

On July 10, 2025, Licensing Program Analyst (LPA) Brandon Lopez made an unannounced visit to the facility to initiate the investigation into the above listed allegation. LPA was greeted and granted entry into the facility by staff after explaining the purpose for the visit. Administrator (AD) Jane Kim was notified via telephone and later arrived to assist with the inspection. The facility is a two story building with resident bedrooms located on the first floor and second floor. The facility also has additional common areas that include a lobby area, a dining room, a courtyard, and a lounge room. On today's visit, LPA collected pertinent documents such as current resident roster, the current staff roster, and resident records. LPA also conducted six resident interviews and five staff interviews. Additionally, LPA, accompanied by the AD, conducted a tour of the physical plant. LPA inspected six resident bedrooms, which include resident bedrooms on the first and second floor, and observethe state’s words, verbatim · CDSS document, Jul 10, 2025 · control 22-AS-20250703160418

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Allegation investigated: Medication not being administered properly Facility not allowing visitors

Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced complaint visit to initiate an investigation into the above allegations. LPA was greeted and granted entry into the facility and explained the reason for the visit. During the course of the investigation, LPA toured the facility, interviewed staff and residents as well as reviewed and obtained pertinent documentation such as medication training records. Regarding the allegation that medication not being administered properly and facility not allowing visitors, the investigation revealed the following: Facility protocol is to have caregivers/ med techs administering medications in the dining room before meals. Caregivers assist in the dining room with serving meals to residents. Residents may interact with the same caregiver who passed medications during their meal. LPA reviewed medication training records and all staff administering medications have proof of current medication training. Upon entry to the facility,the state’s words, verbatim · CDSS document, Jan 8, 2024 · control 22-AS-20240103132234