Cuesta Rosa Senior Residence

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) De Leon arrived at 10:15 am to conduct a 1 year annual visit to the facility above. LPA met with Administrator, Jessica Bailey and explained the purpose of the visit. A tour of the inside and outside of the facility was conducted. The following was inspected and noted during the annual visit: Infection Control: The facility has a current Infection Control Plan. The facility has a sign in and out binder for visitors at entry with hand sanitizer. The bathrooms have toilet paper, paper towels, and hand soap. The facility has EPA approved disinfectant spray and cleaners. The facility has a 30-day supply of PPE. Quarantined or isolated individuals will have meals and medication delivered to rooms. Staff are trained on infection control and the use of Personal Protective Equipment (PPE). Physical Plant & Environment Safety: The fire extinguisher were charged and tagged 05/20/2026. This facility is a two story building that has 36 resident rooms with 36 bathrooms with one being a shared bathroom. Two common area restrooms and 1 staff restroom. 32 of the rooms have been designated for double occupancy. The fire clearance is approved for a maximum of 40 bedridden residents. The facility is completely fenced with a drive up automatic gate for entry of vehicles and a pedestrian gate the automatically opens and shuts. The facility has an automatic vehicle exiting gate with a pedestrian gate that opens and shuts automatically. The first floor front entrance has a receptionist desk, 10 resident rooms, three staff offices, locked medication room, large living room, kitchen, one locked storage room, two locked mechanical rooms, a locked staff locker room with restroom, locked laundry room, dining room, and a courtyard in the center of the facility with dining room access and the 1st floor residents have patio door access. Continued 809-C The courtyard has a large screened outdoor fireplace. The second floor has 26 residents rooms with 11 rooms having balconies, 1 common area restroom, a large activity room with a small staff office, a beauty parlor, 2 locked storage closets, 1 housekeeping closet, and a back courtyard on the second floor with seating and shaded areas for residents and visitors use. The facility has hard wired dual smoke and carbon monoxide detectors. The lighting and lamps are sufficient for the use of the facility and for resident comfort. Toilet, hand washing and bathing facilities are operational and secured grab bars are present. The showers have textured bottoms. The pathways are clear of any obstructions. Facility is well lit inside and outside for safety. Disinfectant, cleaning solutions and poisons are inaccessible to residents in care and stored in locked storage rooms and laundry room. The facility has sufficient space inside and outside for activities and visiting. The facility has a courtyard patio with furniture and umbrella for shade and resident use. The facility has telephone and internet service for resident use. Operational Requirements: The facility has a current plan of operation on file with the department. The Facility is operating in compliance with the granted fire clearance. The facility has current liability insurance and expires on April 29, 2027. The facility is approved for a capacity of 40. The fire clearance is granted for 40 non-Ambulatory, of which 40 may be bedridden. Hospice is approved for 15. Staffing: The facility currently employes 20 staff, and 2 Administrators. Staff records are kept confidential. Five Staff files were reviewed had current 1st Aid/CPR, Personnel Records/Application, Health screening with TB results, and fingerprint clearance or exemptions. Personnel Records & Training: The facility keeps confidential files for each staff member. LPA reviewed training files and 5 Staff have annual training completed for 20 plus hours from 2026 or 40 plus hours of initial training hired in 2026. Resident Records & Incident Reports: The facility keeps separate files on each resident confidentially. Facility does submit incident reports to the department when required. LPA reviewed 5 resident files for signed Admission Agreements, Safeguard for property and valuables, LIC. 602A Physicians report, Appraisals Needs and Services Plan, and Emergency and ID forms. Food Service: The facility handles and prepares food safely. The facility has 2-day perishables and 7-day non-perishables and plenty extra, to meet the food service requirement. The freezer is kept at 0 degrees and the refrigeration is kept at 40 degrees or lower. All food is covered, stored and marked appropriately. Cleaning solutions and equipment are stored separately from food supplies. Kitchen has a hot tap with safety sign. Continued 809-C Incidental Medical Services: Facility provides assistance in arranging transportation to medical and dental appointments when needed. Residents have on-call doctor that visits facility. The facility uses the Medication Administration Record (MAR) along with the Centrally Stored Medication and Destruct Records (CSMDR). LPA reviewed residents’ medications, no labels were altered, no medications were expired and all medications were kept in their original containers. Disaster Preparedness: The current emergency disaster forms were posted. The facility conducts quarterly disaster drills. Emergency exits and telephone numbers were posted. Keys and Codes are available for staff on all shifts to access full facility in an emergency. Residents with Special Health Needs: The facility does accept dementia residents in care, all sharps, knives, cleaning products and items that can pose a hazard are locked in storage rooms. The facility currently has 4 residents on Oxygen and signs are posted. The facility has 2 residents on hospice services. The facility currently has 13 residents on home health services. Hospice and Home Health Plans are kept up to date and on file at the facility. LPA interviewed 3 staff and 3 residents. Exit interview conducted and copy of report printed for Administrator.the state’s words, verbatim · CDSS document, Jul 17, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) De Leon arrived at 10:00 am to conduct a 1 year annual visit to the facility above. LPA met with Administrator, Jessica Bailey and explained the purpose of the visit. A tour of the inside and outside of the facility was conducted. The following was inspected and noted during the annual visit: Infection Control: The facility has a current Infection Control Plan. The facility has a sign in and out binder for visitors at entry with hand sanitizer. The bathrooms have toilet paper, paper towels, hand soap, and hand washing signs. The facility has EPA approved disinfectant spray and cleaners. The facility has a 30-day supply of PPE. Quarantined or isolated individuals will have meals and medication delivered to rooms. Staff are trained on infection control and the use of Personal Protective Equipment (PPE). Physical Plant & Environment Safety: The fire extinguisher were charged and tagged 03/20/2025. This facility is a two story building that has 36 resident rooms with 36 bathrooms with one being a shared bathroom. 1 common area restrooms and 1 staff restroom. 32 of the rooms have been designated for double occupancy. The fire clearance is approved for a maximum of 40 bedridden residents. The facility is completely fenced with a drive up automatic gate for entry of vehicles and a pedestrian gate the automatically opens and shuts. The facility has an automatic vehicle exiting gate with a pedestrian gate that opens and shuts automatically. The first floor front entrance has a receptionist desk, 10 resident rooms, three staff offices, locked medication room, large living room, kitchen, one locked storage room, two locked mechanical rooms, a locked staff locker room with restroom, locked laundry room, dining room, and a courtyard in the center of the facility with dining room access and the 1st floor residents have patio door access. Continued 809-C The courtyard has a large screened outdoor fireplace. The second floor has 26 residents rooms with 11 rooms having balconies, 1 common area restroom, a large activity room with a small staff office, a beauty parlor, 2 locked storage closets, 1 housekeeping closet, and a back courtyard on the second floor with seating and shaded areas for residents and visitors use. The facility has dual smoke and carbon monoxide detectors and are hard wired. The lighting and lamps are sufficient for the use of the facility and for resident comfort. Toilet, hand washing and bathing facilities are operational and secured grab bars are present. The showers have textured bottoms. The pathways are clear of any obstructions. Facility is well lit inside and outside for safety. Disinfectant, cleaning solutions and poisons are inaccessible to residents in care and stored in locked storage rooms and laundry room. The facility has sufficient space inside and outside for activities and visiting. The facility has a patio with furniture and umbrella for shade and resident use. The facility has telephone and internet service for resident use. Operational Requirements: The facility has a current plan of operation on file with the department. The Facility is operating in compliance with the granted fire clearance. The facility has current liability insurance and expires on April 29, 2026. The facility is approved for a capacity of 40. The fire clearance is granted for 40 non-Ambulatory, of which 40 may be bedridden. Hospice is approved for 15. Staffing: The facility currently employes 17 staff, and 3 Administrators. Staff records are kept confidential. Five Staff files were reviewed had current 1st Aid/CPR, Personnel Records/Application, Health screening with TB results, and fingerprint clearance or exemptions. The facility has an administrative number and all staff are associated to work at all facilities own and operated by the Rose Care Group. Personnel Records & Training: The facility keeps confidential files for each staff member. LPA reviewed training files and 5 Staff have annual training completed for 20 plus hours from 2024-2025 or 40 plus hours of initial training hired in 2025. Resident Records & Incident Reports: The facility keeps separate files on each resident confidentially. Facility does submit incident reports to the department when required. LPA reviewed 5 resident files for signed Admission Agreements, Safeguard for property and valuables, LIC. 602A Physicians report, Appraisals Needs and Services Plan, and Emergency and ID forms. Food Service: The facility handles and prepares food safely. The facility has 2-day perishables and 7-day non-perishables and plenty extra, to meet the food service requirement. The freezer is kept at 0 degrees and the refrigeration is kept at 40 degrees or lower. All food is covered, stored and marked appropriately. Cleaning solutions and equipment are stored separately from food supplies. Kitchen has a hot tap with safety sign. Continued 809-C Incidental Medical Services: Facility provides assistance in arranging transportation to medical and dental appointments when needed. Residents have on-call doctor that visits facility. The facility uses the Medication Administration Record (MAR) along with the Centrally Stored Medication and Destruct Records (CSMDR). LPA reviewed residents’ medications, no labels were altered, no medications were expired and all medications were kept in their original containers. Disaster Preparedness: The current emergency disaster forms were posted. The facility conducts quarterly disaster drills. Emergency exits and telephone numbers were posted. Keys and Codes are available for staff on all shifts to access full facility in an emergency. Residents with Special Health Needs: The facility does accept dementia residents in care, all sharps, knives, cleaning products and items that can pose a hazard are locked in storage rooms. The facility currently has 5 residents on Oxygen and signs are posted. The facility has 2 residents on hospice services. The facility currently has 13 residents on home health services. Hospice and Home Health Plans are kept up to date and on file at the facility. LPA interviewed 3 staff and 3 residents. Exit interview conducted and copy of report printed for Administrator.the state’s words, verbatim · CDSS document, Jul 16, 2025

Type of visit: Prelicensing

At 9:00am on 07/19/2024, Licensing Program Analysts (LPA's) De Leon and Jeffries arrived at the appointment time to conduct the Pre-Licensing visit. LPA's met with Administrator, Jessica Bailey and announced the purpose of the visit. This facility is a brand new build, two story building that has 36 resident rooms with 36 bathrooms and one being a shared bathroom. 2 common area restrooms and 1 staff restroom.32 rooms have been designated for double occupancy. The fire clearance is approved for a maximum of 40 bedridden residents. The facility is completely fenced with a drive up automatic gate for entry of vehicles and a pedestrian gate the automatically opens and shuts. The facility has an automatic vehicle exiting gate with a pedestrian gate that opens and shuts automatically. The first floor front entrance has a receptionist desk, 10 resident rooms, three staff offices, locked medication room, large living room, kitchen, one locked storage room, three locked doors to two mechanical rooms, a locked staff locker room with restroom, locked laundry room, dining room, dinette room, and a courtyard in the center of the facility with dining room access and the 1st floor residents have patio door access. The courtyard has a large outdoor fireplace in need of a screening. The second floor has 26 residents rooms with 11 rooms having balconies, a large activity room with a small staff office, a beauty parlor, 2 locked storage closets, 1 housekeeping closet, and a back courtyard on the second floor with seating and shaded areas for residents and visitors use. The 2nd floor has a large fenced in patio/balcony with furniture and umbrella for shade. LPA reviewed facility emergency evacuation plan and infection control plan to be within regulation requirements. CONTINUED on LIC809-C Administrator and LPA conducted a full physical tour of the facility. LPA's noted that water on both floors were tested and within regulations parameters on this pre licensing visit. The kitchen has all new appliances, and refrigerator and freezer are within required regulation temperatures. LPA's inspected 10 resident rooms 100, 103, 109, 200, 201, 202, 206, 211, 214, and 223 which had appropriate furnishing and linen, bathrooms had non-slip mats, secured grabs are present, all plumbing is working properly. LPA's observed the large activities with ample room for activities indoors and outdoors. Kitchen is clean, safe and sanitary. The facility has emergency food and water supply. The facility has 7 days on Non-perishable and with stock two days of perishables prior to accepting residents in care. The facility has plenty of hygiene and grooming products, EPA approved disinfectant and cleaning supplies. Administrator and LPA's conducted a full review of the pre licensing care tools. LPA's noted that there were no violations, citations or technical violations observed during the full review of the pre-licensing care tools modules. Licensing Program Manager waived COMP III component training on LIC812 due to Administrator has additional facilities currently licensed. Pre licensing is incomplete at this visit, facility courtyard fire place needs screening. Products order, installer scheduled, verified by LPA's for 07/21/2024. LPA De Leon will follow up on 07/22/2024 completion of fire place screening resolution and will document upon completion verification. Exit interview, report read, and report provided. .the state’s words, verbatim · CDSS document, Jul 19, 2024

Type of visit: Office

Facility Type: RCFE Application Type: Initial Capacity: 40 Census (if any clients in care): none COMP II Participants: Jessica Bailey (A) & Arpad Soo (C) Interview Method: Telephone interview On July 8, 2024, applicant/administrator participated in COMP II. Identification of the applicant and administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant and administrator confirmed that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Medications/storage 3. Staffing requirements & Training 4. Pre-Licensing readinessthe state’s words, verbatim · CDSS document, Jul 8, 2024