Rose Valley Redlands

We haven’t transcribed this report yet. The complete document is on the state’s site.

Allegation investigated: Staff transferred resident to another facility without consent.

On 04/14/2026, Licensing Program Analyst (LPA) Beena Singh arrived at the facility, greeted by House Manager Mistie Felton and was granted entry to the facility. Facility Vice President-Iren Creighton was informed and arrived during the visit, LPA Singh introduced herself to the Facility Vice President-Iren Creighton and stated the purpose of this visit. Second Allegation:- Second Allegation:-Staff transferred resident to another facility without consent. Licensing Program Analyst(LPA) Singh interviewed Staff, outside agency, reviewed records. Records review and interviews with Staff and outside agency confirmed that Licensee/Staff informed resident's family about the resident's transfer to the other facility due to R#1s change of condition and needed higher level of care. Unsubstantiated Staff transferred resident to another facility without consent is determined to be Unsubstantiated, as facility Staff/administrator did inform resident's family and transferred resident#1 with consent of the family to another facility. Based on the evidence found during the investigation, the allegations listed above are deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. During today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted where this report LIC9099, 9099C was discussed and provided to Facility Representative, Facility Vice President Iren Creighton.the state’s words, verbatim · CDSS document, Apr 14, 2026 · control 56-AS-20241004092109

The state marks this report as 4 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Magda Malcore made an unannounced visit to the facility to conduct a required annual inspection. LPA was granted entry, met with Mistie Felton, House Manager, and discussed the purpose of the visit. The facility is a Residential Care Facility for the Elderly (RCFE) with a license capacity of (6) and a current census of (6) residents in care. LPA conducted an overall inspection of the facility, which included, but was not limited to, the following: Physical Plant/Environment: The facility is operating in the capacity approved by Community Care Licensing Division (CCLD). Indoor and outdoor passageways are free of obstruction. The facility has no swimming pools or similar bodies of water. Outdoor shaded area is sufficient for resident activities and is enclosed with self-latching gates. The facility is equipped with carbon monoxide/smoke alarms, two (2) fully charged fire extinguishers, covered fireplace, laundry equipment, emergency food/water, hallway lighting, sufficient personal hygiene products, and telephone service.The facility is maintained at a temperature of 74 degrees Fahrenheit (F). Resident bathrooms were operating in a safe and sanitary conditions. The hot water temperature in residents' bathrooms measured 116 degrees F. Resident’s bedrooms were equipped mattresses, bed linen, night stands, chairs, storage space and lighting. The facility has posted in a common area: Community Care Licensing complaint poster, Ombudsman poster, facility license, resident councils rights, disaster evacuation plan and emergency telephone numbers. Sharps, disinfectants, and cleaning solutions were kept locked and inaccessible to residents in care. Food Service: Facility kitchen and dining areas are maintained clean. The facility has sufficient non-perishable and perishable food supply for residents in care. The facility has a sample menu posted in the kitchen area. Care & Supervision: Facility has 24-hour, 7 days a week care staff. Staff working have criminal record clearances and first Aid/CPR certifications. Medications: Facility maintains records of resident's medications and medications were kept locked. Record Review: Three (3) staff files reviewed were observed to be complete. Four (4) resident files reviewed were observed to be complete. The facility maintains records of the Administrator’s certification, liability insurance, client registry, staff emergency drill training, infection control plan, emergency and disaster plan. Annual inspection is complete with no deficiencies cited. An exit interview was conducted where this report was discussed and a copy provided to House Manager Felton at the conclusion of the visit.the state’s words, verbatim · CDSS document, Dec 11, 2025

The state marks this report as 4 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Allegation investigated: Staff yells at residents in care. Staff denies resident water. Staff do not ensure resident is provided with toileting assistance.

On 7/14/2025 at 3:20 PM, Licensing Program Analyst (LPA) Eldin Serrano made an unannounced visit to the facility to deliver the findings of the above allegations. LPA Serrano met with House Manager Mistie Felton to explain the purpose of the visit. The investigation consisted of file review, interviews with facility staff and residents as well as facility observation. Allegation #1: Staff yells at residents in care. – Based on information received during interviews LPA was unable to corroborate the allegation. 4 out 5 residents, 1 resident refused to be interviewed and 3 out of 4 staff stated that they have not witnessed/observed any staff yelled at any residents in care. Allegation #2: Staff denies resident water. - Based on information received during interviews LPA was unable to corroborate the allegation. 4 out 5 residents, 1 resident refused to be interviewed and 3 out of 4 staff stated that they have not witnessed/observed any staff denied water to any residents in care. *** Continuation in LIC9099C *** Unsubstantiated Allegation #3 Staff do not ensure resident is provided with toileting assistance. - Based on interviews, information received during the investigation LPA was unable to corroborate the allegation. Interviews indicated that most residents does not need help for toileting and they have not witness any staff not providing assistance to a residence in need of toileting assistance. During the investigation, LPA did not find evidence to corroborate the allegations. Based on the evidence, the allegations mentioned above are UNSUBSTANTIATED. A finding that the complaint is UNSUBSTANTIATED means although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated at this time. An exit interview was conducted where this report, LIC9099 was discussed and provided to House Manager Mistie Felton.the state’s words, verbatim · CDSS document, Jul 14, 2025 · control 56-AS-20240411114451

Allegation investigated: Staff did not inform resident’s physician of resident’s change of condition Staff did not provide adequate medication assistance to residents in care Staff refuse to call an ambulance for residents in care Staff threatened residents in care Staff did not ensure sufficient food items were available at the facility for residents in care Staff did not prevent residents from engaging in inappropriate interactions Staff yelled at residents in care Staff did not assist residents that sustained falls Centrally stored medications are accessible to residents in care

Licensing Program Analysts (LPAs) Sarina Ramirez and Becky Mann conducted an unannounced visit to the facility to conduct a complaint investigation on the above allegations. LPAs met with House Manager Mistie Felton, and discussed the purpose of the visit. Regarding the allegation #1 LPA Ramirez and LPA Mann conducted 3 staff interviews. 3 out of the 3 staff informed LPAs staff inform innovage as soon as they observe a change or condition LPA Ramirez and LPA Mann conducted 5 resident interviews. 5 out of the 5 residents informed LPAs they get assessed yearly by a physician, LPAs observed and reviewed records showing all residents have up to date physician reports. Regarding the allegation #2 LPA Ramirez and LPA Mann conducted 3 staff interviews. 3 out of the 3 staff informed LPAs they provide adequate medication assistance to residents Unsubstantiated LPA Ramirez and LPA Mann conducted 5 resident interviews. 5 out of the 5 residents informed LPAs staff provide adequate medication assistance. Regarding the allegation #3 LPA Ramirez and LPA Mann conducted 3 staff interviews. 3 out of the 3 staff informed LPAs staff do not refuse to call ambulance for residents in care. LPA Ramirez and LPA Mann conducted 5 resident interviews. 5 out of the 5 residents informed LPAs staff do not refuse to call ambulance for residents when ambulance services is needed. Regarding the allegation #4 LPA Ramirez and LPA Mann conducted 3 staff interviews. 3 out of the 3 staff informed LPAs staff do not threaten residents in care. LPA Ramirez and LPA Mann conducted 5 resident interviews. 5 out of the 5 residents informed LPAs staff do not threaten the residents. Regarding the allegation #5 LPA Ramirez and LPA Mann conducted 3 staff interviews. 3 out of the 3 staff informed LPAs staff ensure there is sufficient food items available at the facility for residents in care. 3 out of the 3 staff stated they go grocery shopping weekly. LPA Ramirez and LPA Mann conducted 5 resident interviews. 5 out of the 5 residents informed LPAs facility has sufficient food items available for all residents in care. Regarding the allegation #6 LPA Ramirez and LPA Mann conducted 3 staff interviews. 3 out of the 3 staff informed LPAs there is no inappropriate interactions with residents in care at the facility. LPA Ramirez and LPA Mann conducted 3 resident interviews. 3 out of the 3 residents informed LPAs they do not engage in inappropriate interactions with other residents. Regarding the allegation #7 LPA Ramirez and LPA Mann conducted 3 staff interviews. 3 out of the 3 staff informed LPAs staff do not yell at residents in care. LPA Ramirez and LPA Mann conducted 5 resident interviews. 5 out of the 5 residents informed LPAs staff do not yell at residents. Regarding the allegation #8 LPA Ramirez and LPA Mann conducted 3 staff interviews. 3 out of the 3 staff informed LPAs staff assist residents that sustain falls LPA Ramirez and LPA Mann conducted 5 resident interviews. 5 out of the 5 residents informed LPAs they have not fallen at the facility. Regarding the allegation #9 LPA Ramirez and LPA Mann conducted 3 staff interviews 2 out of the 3 staff stated the medication is centrally locked and inaccessible to residents in care. 1 out of the 3 staff stated they do not administer medication. LPAs observed medication is locked in a cabinet inaccessible to residents in care Based on LPAs observations, record review, and interviews, the above allegations are Unsubstantiated; meaning that although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. An exit interview was conducted where this report was discussed and a copy with appeal rights was provided to House Manager Mistie Felton at the conclusion of the visit.the state’s words, verbatim · CDSS document, Nov 25, 2024 · control 56-AS-20241120141939

Allegation investigated: Staff do not have a fire evacuation plan at the facility Staff do not have an infection control plan at the facility Staff are not following reporting requirements Staff left residents unattended

Licensing Program Analysts (LPAs) Sarina Ramirez and Becky Mann conducted an unannounced visit to the facility to conduct a complaint investigation on the above allegations. LPAs met with House Manager Mistie Felton, and discussed the purpose of the visit. Regarding the allegation #1 LPA Ramirez and LPA Mann conducted 3 staff interviews. 3 out of the 3 staff informed LPAs staff has a fire evacuation plan, staff stated their meeting point is outside infront of the facility. LPAs observed and reviewed records the last fire drill conducted was 10/07/24 Regarding the allegation #2 LPA Ramirez and LPA Mann conducted 3 staff interviews. 3 out of the 3 staff informed LPAs staff has a infection control plan, LPAs observed and reviewed records facility has a infection control plan Unsubstantiated Regarding the allegation #3 LPA Ramirez and LPA Mann conducted 3 staff interviews. 3 out of the 3 staff informed LPAs staff follow reporting requirements. Regarding the allegation #4 LPA Ramirez and LPA Mann conducted 3 staff interviews. 3 out of the 3 staff informed LPAs staff do not leave residents unattended. LPA Ramirez and LPA Mann conducted 5 resident interviews. 5 out of the 5 residents informed LPAs staff do not leave residents unattended. Based on LPAs observations, record review, and interviews, the above allegations are Unsubstantiated; meaning that although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. An exit interview was conducted where this report was discussed and a copy with appeal rights was provided to House Manager Mistie Felton at the conclusion of the visit.the state’s words, verbatim · CDSS document, Nov 25, 2024 · control 56-AS-20241120141939

Allegation investigated: Staff consume liquor while on shift Staff do not have fingerprint clearance Staff lock facility doors to prevent residents from leaving Staff insert suppositories to residents in care Staff did not complete required trainings Staff facility records are falsified Staff did not maintain resident records Residents are not provided proper food service Staff did not ensure resident’s diapering needs were met

Licensing Program Analysts (LPAs) Sarina Ramirez and Becky Mann conducted an unannounced visit to the facility to conduct a complaint investigation on the above allegations. LPAs met with House Manager Mistie Felton, and discussed the purpose of the visit. Regarding the allegation #1 LPA Ramirez and LPA Mann conducted 3 staff interviews. 3 out of the 3 staff informed LPAs staff do not consume liquor while on shift. LPA Ramirez and LPA Mann conducted 5 resident interviews. 5 out of the 5 residents informed LPAs staff do not consume liquor while on shift. Regarding the allegation #2 LPA Ramirez and LPA Mann conducted 3 staff interviews. 3 out of the 3 staff informed LPAs all staff have fingerprint clearance, LPAs observed and reviewed records showing all staff Unsubstantiated have fingerprint clearance. Regarding the allegation #3 LPA Ramirez and LPA Mann conducted 3 staff interviews. 3 out of the 3 staff informed LPAs staff do not lock doors to prevent residents from leaving, 2 out of the 3 staff stated doors are locked at night when residents are sleeping. LPA Ramirez and LPA Mann conducted 5 resident interviews. 5 out of the 5 residents informed LPAs the doors are not locked to prevent them from leaving Regarding the allegation #4 LPA Ramirez and LPA Mann conducted 3 staff interviews. 3 out of the 3 staff informed LPAs staff do not insert suppositories in residents. LPA Ramirez and LPA Mann conducted 5 resident interviews. 5 out of the 5 residents informed LPAs staff do no insert suppositories in residents. Regarding the allegation #5 LPA Ramirez and LPA Mann conducted 3 staff interviews. 3 out of the 3 staff informed LPAs staff complete all required trainings. LPAs observed and reviewed records all staff have all required trainings. Regarding the allegation #6 LPA Ramirez and LPA Mann conducted 3 staff interviews. 3 out of the 3 staff informed LPAs staff records are not falsified. LPAs observed and reviewed records and no staff records are falsified. Regarding the allegation #7 LPA Ramirez and LPA Mann reviewed and observed staff maintain resident records. Regarding the allegation #8 LPA Ramirez and LPA Mann conducted 3 staff interviews. 3 out of the 3 staff informed LPAs residents are provided proper food service LPA Ramirez and LPA Mann conducted 5 resident interviews. 5 out of the 5 residents informed LPAs residents are provided with proper food service. Regarding the allegation #9 LPA Ramirez and LPA Mann conducted 3 staff interviews. 3 out of the 3 staff informed LPAs there are no residents in care that need assistance with diaper needs, however 3 out of the 3 staff stated they will assist with diaper needs if needed. LPA Ramirez and LPA Mann conducted 5 resident interviews. 5 out of the 5 residents informed LPAs they do not need diaper assistance and can independently use the restroom on their own. Based on LPAs observations, record review, and interviews, the above allegations are Unsubstantiated; meaning that although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. An exit interview was conducted where this report was discussed and appeal rights were provided to House Manager Mistie Felton at the conclusion of the visit.the state’s words, verbatim · CDSS document, Nov 25, 2024 · control 56-AS-20241120141939

Type of visit: Required - 1 Year

Licensing Program Analysts (LPAs) Sarina Ramirez and Becky Mann made an unannounced visit to the facility to conduct a required annual inspection. LPAs met with House Manager Mistie Felton, and discussed the purpose of the visit. The facility is a Residential Care Facility for the Elderly (RCFE). License capacity of (6) with a current census of (6). LPAs conducted an overall inspection of the facility, which included, but was not limited to, the following: Physical Plant: Indoor passageways are free of obstruction. The facility has sufficient lighting and is maintained at a comfortable temperature. Resident’s bathrooms are equipped with grab rails and operating in safe and sanitary conditions. The hot water temperature in residents' bathrooms measured between 106 to 111 degrees F. Resident’s bedrooms have sufficient lighting and bedroom furniture is in good repair. Facility has operating carbon monoxide alarms, laundry service, and telephone service. The facility has sufficient linens, towels, and personal hygiene items for residents. The facility has posted in a common area, Community Care Licensing complaint poster, Ombudsman poster,personal rights, facility license, personnel report, resident roster, disaster evacuation plan and emergency telephone numbers. Yards/Outside: Outdoor passageways are free of obstruction. The facility has no bodies of water accessible to residents in care. The facility is enclosed with self-latching gates. Outdoor shaded area is sufficient for resident activities. Food Service: Facility has sufficient non-perishable and perishable food supply for residents in care. The refrigerator and freezer are operating in a healthful manner. Sharps, Disinfectants, and other cleaning solutions were kept locked and stored away inaccessible to residents in care.. Care & Supervision: Facility has 24-hour/7 days a week care staff. Staff working have criminal record clearances or exemptions through the Department. Record Review: LPAs reviewed 6 resident files and 5 staff files. Licensee did not maintain a transfer of criminal record for S1, staff is not associated with the facility, deficiency will be issued. LPA observed facility's last emergency drill was conducted on 10/07/24 Medical Related Services: All medication is centrally stored, administered as prescribed and kept in a locked closet, inaccessible to residents in care. Deficiencies were cited during today's visit and a plan of correction was discussed with facility representative, Mistie Felton. An exit interview was conducted and copies of the licensing reports with appeal rights were provided to the House Manager Mistie Felton at the conclusion of the visit.the state’s words, verbatim · CDSS document, Nov 25, 2024

Type of visit: Case Management - Deficiencies

Licensing Program Analysts (LPAs) Magda Malcore and Renese Howell-Small initiated a case management based on deficiencies observed during complaint investigation #56-AS-20241004092109 visit. LPA's met with House Manager, Mistie Felton and informed the purpose of the visit. LPAs requested to review files for resident #1 (R1) who left the facility in August 2024 and resident #2 (R2) who left in July 2024. LPAs were informed by the House Manager that the facility not longer had record of both residents. A deficiency is being cited in accordance of Title 22, division 6, of the California Code of Regulations. An exit interview was conducted where this report and a plan of correction was discussed. A copy of this report was provided with Appeal Rights to the House Manager at the conclusion of the visit.the state’s words, verbatim · CDSS document, Oct 7, 2024

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87506(e) · Plan of correction due date: Oct 14, 2024

87506 Resident Records(e) Original records or photographic reproductions shall be retained for a minimum of three (3) years following termination of service to the resident. This requirement is not met as evidenced by: The licensee did not comply with the section cited above by not maintaining records for resident #1 and resident #2 at the facility for 3 years after termination of services, which poses a potential health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Oct 7, 2024

Plan of correction: The Licensee/Administrator shall submit a self-certified statement of understanding on the regulation cited and submit the statement to the Licensing Agency by POC due date.

Allegation investigated: Staff are mismanaging resident's medication Staff are engaging in inappropriate behaviors in the presence of residents Staff did not keep resident's personal information confidential

Licensing Program Analyst (LPA) Magda Malcore conducted an unannounced visit to the facility to deliver findings on the above allegations. LPA met with House Manager, Mistie Felton, and discussed the purpose of the visit. Regarding the allegation, staff are mismanaging resident's medication, staff interviewed deny mismanaging resident’s medications. Four (4) out of five (5) residents interviewed deny that staff have mismanaged their medications. Regarding the allegation, staff are engaging in inappropriate behaviors in the presence of residents, staff interviewed deny engaging in inappropriate behaviors in the presence of residents. Four (4) out of five (5) residents interviewed deny that staff are engaging in inappropriate behaviors in their presence. Regarding the allegation, staff did not keep resident's personal information confidential, staff interviewed deny not keeping resident’s personal information confidential. Four (4) out of five (5) residents interviewed deny that staff do not keep their personal information confidential. Unsubstantiated Based on LPA observations and interviews with residents and staff, the allegations are Unsubstantiated. An unsubstantiated finding means that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. An exit interview was conducted where this report was discussed and a copy with Appeal Rights was provided to the House manager, Felton at the conclusion of the visitthe state’s words, verbatim · CDSS document, Jun 12, 2024 · control 56-AS-20231227145548

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87303(a) · Plan of correction due date: Jun 13, 2024

The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement is not met as evidenced by: The licensee did not comply with the section cited above by not obtaining outside pest control services to ensure the facility was free of mice, which poses a potential health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Jun 12, 2024

Plan of correction: The Licensee/Administrator shall submit to the Licensing Agency proof of pest control services contracted by 6/13/2024 and submit documentation completed services by 6/18/2024.

Allegation investigated: Staff are not properly cleaning the floors

Licensing Program Analyst (LPA) Magda Malcore conducted an unannounced complaint visit to the facility. LPA met with Mistie Felton, House Manager and discussed the purpose of the visit. Regarding the allegation, staff are not properly cleaning the floors, LPA observed the facility floors to be clean, two (2) staff interviewed deny that the floors are not properly clean, four (4) residents interviewed stated that the facility overall is kept clean. Based on LPA observations and interviews, the above allegation is Unsubstantiated. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. An exit interview was conducted where this report was discussed, and a copy was provided to the House Manager at the conclusion of the visit. Unsubstantiated LPA conducted a tour of resident’s bedrooms. LPA observed a broken glass window in resident #1 (R1’s) bedroom. Based on LPA observations, the allegation is SUBSTANTIATED. A finding that the complaint is SUBSTANTIATED means that the allegation is valid because the preponderance of the evidence standard has been met. An exit interview was conducted where reports LIC9099/LIC9099-C/ LIC9099-D were discussed. A copy of the reports with Appeal Rights were provided to the House Manager at the conclusion of the visit.the state’s words, verbatim · CDSS document, Jan 4, 2024 · control 56-AS-20231227145548

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87303(a) · Plan of correction due date: Jan 26, 2024

(a) The facility shall be clean, safe, sanitary and in good repair at all times. This requirement is not met as evidenced by: LPA observed missing tile pieces and loose tile pieces around the kitchen sink exposing rock and gravel. LPA conducted a toured of resident’s bedrooms. LPA observed a broken glass window in resident #1 (R1’s) bedroom; which poses a potential health, safety, or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Jan 4, 2024

Plan of correction: Licensee shall submit to the licensing agency proof of repairs or a self-certification that repairs have been made by POC due date.

The state marks this report as 6 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.