Roseville Residential

Allegation investigated: Staff did not refund authorized representative after residents death

Licensing Program Analyst (LPA) Bethany Mirlohi arrived unannounced to deliver complaint investigation findings. LPA spoke with Administrator, Aileen Mendoza and Tony Hoang, during today's inspection. A complaint was received alleging staff did not refund authorized representative after residents death. The responsible party removed most personal belongings on November 16, 2025. Hospice and a durable medical equipment provider retrieved some equipment on November 17 and November 20, respectively. However, documentation confirms that the resident’s hospital bed remained in the facility and was never removed. The Admission Agreement, signed and initialed by the responsible party, specifies that refunds are issued only after full removal of personal property. Facility records, logs, door camera images, and written communications show that the responsible party acknowledged responsibility for arranging removal of the bed and that the bed belonged to the resident. LPA was unable to obtain a receipt from the DME company showing ownership of the bed. Because the bed remained on site, the refund condition was not met. Continuation on 9099-C. Unsubstantiated Although no refund was owed under the agreement, the facility offered and issued a $750 courtesy refund, which the responsible party accepted in writing. Based on the evidence reviewed, the facility complied with contractual and regulatory requirements. The allegation is unsubstantiated. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove that the alleged violations occurred. Exit interview conducted and copy of report provided.the state’s words, verbatim · CDSS document, Dec 29, 2025 · control 59-AS-20251201101836

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Bethany Mirlohi arrived unannounced to conduct an annual inspection. LPA met with Administrator Aileen Mendoza and Tony Hoang during today's inspection. LPA toured facility with caregiver to ensure health and safety of residents in care. LPA toured 4 resident rooms, 1 staff room, 2 bathrooms, kitchen, common living spaces, backyard and the garage area. In the areas toured no immediate health, safety, or personal rights violations were observed. Hot water was measured at 107 degrees. LPA toured the backyard and all exits are accessible and unlocked. There is a locked storage for medications and toxins. Food supply is adequate for 2-day perishable and 7-day nonperishable. LPA observed an adequate amount of linens and found the first aid kit to be complete. LPA reviewed 2 of 3 resident files and 1 staff files. A review of staff records indicates that all facility staff has received criminal record clearances and/or are associated to this facility. Staff records reviewed indicated current first aid certificates and training completed. LPA observed a copy of current liability insurance. LPA observed unlocked medications in the refrigerator in the kitchen. Deficiencies cited on 809-D. Exit interview conducted and copy of report given.the state’s words, verbatim · CDSS document, Dec 4, 2025

Type of visit: Case Management - Incident

Licensing Program Analyst (LPA) Bethany Mirlohi arrived unannounced to conduct a case management visit. LPA met with Caregiver Cristine Mendoza during today's inspection and spoke to Administrator Aileen Mendoza over the phone. LPA arrived today to gather further information regarding incident reports sent into our department. LPA reviewed resident files and documents and conducted interviews. At this time no deficiencies cited due to today's inspection. Exit interview conducted and copy of report provided.the state’s words, verbatim · CDSS document, Nov 6, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Cassandra Mikkelson arrived unannounced to conduct an annual inspection. LPA conducted an inspection of the care home to ensure compliance with Title 22 regulations. LPA observed four (4) resident rooms and four (4) common area bathrooms. LPA observed rooms to be properly furnished, with appropriate bedding and lighting. The bathrooms were in sanitary condition, properly maintained, and the hot water temperature was observed to be 108.1 degrees F. LPA checked the kitchen area for the ability to prepare and store food. Care home has required (2) two day perishable and (7) seven day non-perishable food supply on hand. Smoke detectors and carbon monoxide detectors are operational in the care home. Fire extinguishers and first aid kit are maintained and ready for emergency use. LPA checked medication storage and found medications to be locked away and inaccessible to the residents. LPA reviewed six (6) resident files, three (3) staff files and two (2) resident medications. Facility has a current copy of certificate of liability insurance and LPA obtained a copy. As a result of this visit, no deficiencies were cited pursuant to California Code of Regulations, Title 22, Division 6, Chapter 8. Exit interview was conducted with Administrator.the state’s words, verbatim · CDSS document, Dec 16, 2024

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Bethany Mirlohi arrived unannounced to conduct a case management visit. LPA spoke with Administrator Aileen Mendoza over the phone. Currently there are 3 residents that reside at the facility. LPA arrived to the facility to discuss their vendorization with Regional Center. LPA spoke to the administrator concerning regulations and forms that will need to be in resident files. No health and safety violations observed. No deficiencies cited during today's inspection. Exit interview conducted. Copy of report provided.the state’s words, verbatim · CDSS document, Apr 18, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Bethany Mirlohi arrived unannounced to conduct an annual inspection. LPA met with Administrator Aileen Mendoza and Tony Hoang during today's inspection. LPA toured facility with caregiver to ensure health and safety of residents in care. LPA toured 5 resident rooms, 1 staff room, 2 bathrooms, kitchen, common living spaces, backyard and the garage area. In the areas toured no immediate health, safety, or personal rights violations were observed. Hot water was measured at 105 degrees. LPA toured the backyard and all exits are accessible and unlocked. There is a locked storage for medications and toxins. Food supply is adequate for 2-day perishable and 7-day nonperishable. LPA observed an adequate amount of linens and found the first aid kit to be complete. LPA reviewed 2 of 4 resident files and 1 staff files. LPA reviewed medications of two residents comparing with Centrally Stored Medication Record and physician orders. A review of staff records indicates that all facility staff has received criminal record clearances and/or are associated to this facility. Staff records reviewed indicated current first aid certificates and training completed. LPA observed a copy of current liability insurance. No deficiencies cited during today's inspection. Exit interview conducted.the state’s words, verbatim · CDSS document, Dec 7, 2023

The state marks this report as 2 pages; the online copy we transcribed has 1. You can request the full file from the county licensing office.