Rosemary Warmlands Senior Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Cheryl Goodrich arrived at 11:51 a.m. to conduct an unannounced annual visit. LPA met Caregiver Liza Macalma at the front door and was granted entry. The Administrator Kristine Skoglin at 12:24 p.m. The purpose of today’s visit is to inspect the facility to ensure that the facility is following California Code of Regulations, Title 22, Division 6. Facility is approved for 6 non-ambulatory residents. The facility has an approved hospice waiver for 6 residents. Infection Control: The facility has an approved infection control plan and a surplus of supplies for infection control including but not limited to mask, gloves, gowns, first aid kit, and cleaning supplies. Physical Plant and Environmental Safety: The facility is a two-story home. The facility temperature read at 75 degrees. The facility consists of 6 resident bedrooms, and 6 bathrooms, living room, kitchen, and backyard. The bedrooms are furnished with tv, lighting, closet space, and dresser. The beds are clean and have clean linens and the pathways are clean and clear of obstruction. The bathroom temperature read at 107 degrees within regulation near the kitchen and inaccessible to residents. The upstairs portion of the home contains the administrative office and staff bedrooms. The ARF and has a current fire clearance for the facility, smoke and carbon monoxide detectors and fire extinguishers and are in working order. Personnel Records-Training: The staff records are completed with fingerprint clearance, Health screening for TB, CPR/First Aid training, and in-service trainings, including but not limited to Alzheimer/ Dementia Care, Medication Training, and Hospice Care Training. Client Records-Incident Reports: The facility has identification and emergency information, physician’s report, resident appraisal, hospice documentation, physician's orders, client rights, and admissions agreement. (Continued on LIC809-C) (Continued from LIC809) Client Rights-Information: The facility has client rights information posted in the facility. Food Service: 7-day non-perishable and 2 day of perishable food supply was observed, and all food was properly stored and available. Health- Related Services: The facility has a medication logbook and the facility documented the resident’s medication and is in compliance with physician’s orders and regulations. Disaster Preparedness: The facility has a disaster plan and has posted the evacuation plan, visible for staff and residents in care. The last fire drill was completed 05/19/23. The facility has emergency supply of food and water. Summary: Based on today's visit, no deficiencies were observed at this time. An exit interview was conducted with the Administrator Kristine Skoglin and a copy of this report was printed Signature below confirms receipt of these rights.the state’s words, verbatim · CDSS document, Sep 18, 2023

Type of visit: Required - 1 Year

On September 7, 2022, Licensing Program Analyst (LPA), Venus Mixson arrived at the above facility for an unannounced annual with emphasis on infection control. LPA Mixson was greeted and granted entry by Administrator, Kristine Skoglin introduced self and stated the purpose of the visit. Present in the facility were 6 clients and 3 Caregivers. There are currently no cases of COVID-19 within the facility. LPA Mixson toured the facility and made observations pertaining to the facility's infection control measures. LPA observed sufficient hand hygiene supplies, sufficient cleaning and disinfecting provisions and the proper use of face coverings. The facility has a designated infection control lead person who has been tasked with tracking all COVID-19 cases and/or suspected cases, ensuring PPE supplies are maintained, and cleaning and disinfection provisions are in adequate quantities. LPA Mixson later discussed infection control practices and procedures with Administrator. An exit interview was conducted and a copy of this report, along with the LIC 811, was provided to Administrator.the state’s words, verbatim · CDSS document, Sep 7, 2022

Type of visit: Case Management - COVID-19

Licensing Program Analyst Tricia Danielson, and County of San Diego Nurse HAI Site Assessment Contractors, Robert Montillano and Sandra Brackman conducted an announced on-site visit. The team identified themselves and discussed the purpose of the visit with Administrator, Kristine Skoglin. The Department conducted the on-site visit to provide technical assistance and to evaluate the facility's disinfection, testing surveillance, screening protocols as well as the use of personal protective equipment related to COVID-19. During today's visit, the team interviewed Skoglin and conducted a walk-through of the facility. A debriefing was conducted with Skoglin at the conclusion of the visit. During today's visit, no deficiencies were issued. An exit interview was conducted with Skoglin and a copy of this report was provided.the state’s words, verbatim · CDSS document, May 13, 2022

Type of visit: Post Licensing

Licensing Program Analyst (LPA) Carmen Lopez conducted an unannounced visit to conduct a post-licensing inspection to ensure that the facility is operating in compliance with California Code of Regulations, Title 22, Division 6. LPA introduced herself, disclosed the purpose of the visit and was granted entry into the facility by Melodia Caluza, designated Managing Care staff. Licensee Kristine Skoglin later joined the inspection. A tour of the facility was conducted inside and out. LPA conducted a general overall inspection, which included, but was not limited to, infection control protocols. During today's inspection LPA observations include the following: Symptom screening procedures for staff, residents and visitors; posted signs regarding visitor policy, promoting hand washing, cough and sneeze etiquette and other infection control procedures; testing plan and procedures was discussed; plans for containing infections, PPE supplies procedures and training; and disinfection procedures. All indoor and outdoor passageways were free from obstructions. The facility’s indoor temperature was 74 degrees Fahrenheit. No pools were observed. A fountain was observed with rocks inside the fountain. According to Licensee Skoglin there are no firearms or ammunition stored in the facility. Cleaning supplies and toxins were locked in an inaccessible cabinet to the residents. LPA toured resident bedrooms. The rooms had the required furnishings and sufficient lighting. Licensee provided the residents with clean linens, in good repair, and sufficient hygiene products for personal use. The facility had functioning carbon monoxide detectors and smoke detectors that met statutory regulations. A one week’s non-perishable food supply is maintained on the property. Perishable food supply is maintained for two days. All food was properly stored and made available to residents. Medications were observed to be labeled and in a locked a cabinet that is inaccessible to residents. Based on today’s inspection, no deficiencies were observed. An exit interview was conducted with Licensee Skogin. A copy of this report, along with the Administrator Rights (01/2016) was emailed to Licensee Skoglin at the conclusion of the visit. LPA requested Licensee to send LPA an electronic message reply confirming receipt of these documents.the state’s words, verbatim · CDSS document, Feb 14, 2022

The state marks this report as 5 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Carmen Lopez conducted an announced Pre-Licensing and Component III inspection at a Residential Care Facility for the Elderly for a change of ownership on today's date to inspect the facility for compliance with Title 22, Division 6, Chapter 8 of the California Code of Regulations and the Health & Safety Code. After arriving at the facility, LPA identified herself, disclosed the purpose of the visit and was granted entry by the Kristine M. Skoglin, Licensee. LPA toured the physical plant, inside and out, and observed the following: Resident accommodations were in compliance with regulations, including furnishings, linens, and personal hygiene items; resident bathrooms were equipped with non-skid flooring, and water temperatures measured at: kitchen faucet #1 117.1 degrees Fahrenheit (F), faucet #2 at 111.8 degrees F, bathroom in bedroom #1 112.6 degrees F, hallway bathroom at 109.4 degrees F, bathroom in bedroom #2 113.8 degrees F, bathroom in bedroom #3 109.8 degrees F, bathroom in bedroom #4 108.0 degrees F, bathroom in bedroom #5 115.9, bathroom in bedroom #6 112.5 degrees F, laundry room at 112.3 degrees F; the facility’s ambient room temperature was 75 degrees F at the time of the visit; medications will be stored in a locked cabinet in the back. Staff records were kept in a secured area in the business office; Resident records were kept in a locked cabinet in the back area. Food service was within the requirements of regulations, including dishes, utensils, food storage, and a seven (7) day supply of non-perishables; the two (2) day supply of perishables will be bought once clients are admitted. Knives and sharp objects were inaccessible to residents in care; toxic substances were stored in a locked cabinet; first aid kits and required supplies were stored in a the back area; the first aid manual was purchased and will be at the facility prior to resident’s acceptance. Activity supplies and sufficient space in which to conduct activities were present; fire extinguishers were present throughout the facility; smoke and carbon monoxide detectors were present and operable; required facility postings were present and visible in the common area of the facility. According to the Licensee, there are no guns, weapons, or ammunition stored on the facility property. The facility does not have a swimming pool or bodies of water. LPA conducted and completed the Component III with the Licensee Kristine M. Skoglin during the visit. LPA verified her understanding of Title 22 continuing requirements, including physical environment, reporting requirements, personnel and resident records, incidental medical care, health related services and activities. No deficiencies were observed during today's visit as all items reviewed during the visit are in compliance with Title 22, Division 6, Chapter 8 of the California Code of Regulations and the Health and Safety Code. The Licensee was advised that the application is pending management final review and approval. An exit interview was conducted with her and a copy of this report and Applicant Rights (LIC 9058) were provided to her via electronic mail; she expressed to LPA that she would send an email confirmation upon receipt of these documents.the state’s words, verbatim · CDSS document, Sep 3, 2021

Type of visit: Office

Facility Type: RCFE Application Type: INC Capacity: 6 Census (if any clients in care): NO Method: Telephone at CAB COMP II Participants: Kristine Skoglin (Applicant/Administrator) Applicant/Administrator participated in COMP II at CAB via telephone with analyst at CAB. Identification of the Applicant and Administrator was verified by providing California Driver License number. During COMP II, Applicant and Administrator confirmed the understanding of Title 22. Component II was successfully completed. Applicant and Administrator were advised to email/fax signed LIC 809 with copy of photo ID to CAB. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Staff qualifications and responsibilities 3. Applicant and Administrator qualifications 4. Program policy: Abuse, admission agreement, medication management, reporting incidents to CCL, restricted & prohibited conditions 5. Grievances, Complaints, Community resources 6. Physical plant, food service Application document review and technical assistance: Criminal record clearance, Health screening, Fire clearance, First Aid/CPR certificate, Administrator certificate, Financial verification, Pre-licensing inspection, Compliance history, Control of propertythe state’s words, verbatim · CDSS document, Aug 17, 2021