Rosewood Residence

Type of visit: Required - 1 Year

On 11/19/2025 at 10:00 AM, Licensing Program Analyst (LPA) Ardalan Gharachorloo arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Administrator, Elisa Empig and explained the purpose of the visit. LPA toured facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 70 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 117.5 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of non-perishable and 2 day of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents. Smoke detectors and carbon monoxide detectors were in operating condition during visit. Fire extinguisher was last serviced on 07/24/2025. Emergency Disaster Plan was last posted and reviewed on 11/19/2025. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 10/12/2025. LPA reviewed 5 residents records and 5 staff records; all were complete. LPA also reviewed a sample of resident’s medications. The following documents were reviewed during the visit: LIC 500 Personnel Report LIC 610E Emergency Disaster Plan, Liability Insurance, and Current Administrator’s Certificate. No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Nov 19, 2025

Type of visit: Required - 1 Year

On 11/01/2024 around 12:00 PM, Licensing Program Analyst (LPA) L Holmes arrived unannounced to conduct a required 1-year Annual Inspection. LPA was greeted by one Care Staff and Elisa Empig, Administrator (ADM), and explained the purpose of the visit. Standard Certificate #6001609740 Exp: 12/28/2024. LPA and ADM toured the facility including but not limited to the common areas, dining room, bathrooms, kitchen, bedrooms and garage. The facility consists six (6) residents. The residents were dining and engaged in activities. Outdoor and indoor passageways were free of obstruction. There were not any bodies of water present. A comfortable temperature was maintained at 71 degrees Fahrenheit (F). LPA observed lighting in all areas to be adequate for the comfort and safety of the residents. The hot water temperature in the shared restroom was measured at 116.2 degrees (F). The shared restrooms had paper towels, soap and garbage cans; all areas were safe and sanitary. PPE, sanitizer, and paper goods remain sufficient. There is a 2-day supply of perishable foods and a 7-day supply of non-perishable foods. Smoke/carbon monoxide detectors were in operating condition during visit. Fire extinguisher was observed full and serviced 06/26/24. Emergency Disaster Plan is updated. Safety drills are rotational and last performed on 09/24/24. LPA reviewed four (4) staff files, and six (6) resident files. The following forms are to be updated and submitted to CCLD: -LIC500 Personnel Report & Resident Roster -LIC308 Designation of Administrative Responsibility (Reviewed) -LIC610E Emergency Disaster Plan (Reviewed) -An updated copy of Administrator Certificate(s) (Reviewed) -Liability Insurance (Reviewed) Exit interview conducted and a copy of this report provided to Elisa Empig, Administrator (ADM)the state’s words, verbatim · CDSS document, Nov 1, 2024

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.

Type of visit: Required - 1 Year

On 12/20/2023 at 4:00pm, Licensing Program Analysts (LPAs) L. Hall and T. Syess-Gibson, conducted an unannounced 1-Year Required inspection. LPAs met with Joevy Madamba, Caregiver and explained the purpose of the visit. Administrator, Helen Herbert, arrived at 4:19pm. The facility’s fire clearance was approved for four (4) non-ambulatory and 2 bedridden residents. LPA toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area and back yard. The facility consists of five (5) total bedrooms one (1) is occupied by staff, and one (1) bathroom. All outdoor and indoor passageways are kept free of obstruction. A comfortable temperature is maintained at 70 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 115.3 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of 7-day supply of non-perishable and 2-day of perishable foods. Smoke detectors/ carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 4/27/2023. Emergency Disaster Plan was last posted on 2/10/2023. First aid kit was observed to be complete. Continued on LIC809. Continued from LIC809. Four (5) staff records were reviewed, and all staff have criminal record clearance. All six (6) resident records were reviewed and one (1) did not have current physician's reports. LPA requested the following documents to be submitted to CCLD by 12/29/2023. LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization Resident roster Liability Insurance LPA observed the following deficiencies: At 4;35pm, LPAs observed during record review R1 did not have a current physican's report. At 5:25pm, LPA observed portable heaters in three (3) residents bedrooms. The deficiencies were observed (see LIC809D) and cited from the California Code of Regulation, Failure to submit proof of corrections (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted. A copy of the appeal rights and this report provided.the state’s words, verbatim · CDSS document, Dec 20, 2023

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87307(d)(7) · Plan of correction due date: Dec 29, 2023

87307 Personal Accommodations and Services(d) The following space and safety provisions shall apply to all facilities:(7) Fireplaces and open-faced heaters shall be adequately screened. This requirement was not met as evidence by: Based on observation the Licnesee did not comply with the section cited above in having portable heaters in 3 bedrooms, which poses a potential health and safety risk for persons in care.the state’s words, verbatim · CDSS document, Dec 20, 2023

Plan of correction: Administrator immediately removed heaters out of the bedrooms. Deficiency cleared during visit.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87705(c)(5) · Plan of correction due date: Jan 12, 2024

87705 Care of Persons with Dementia (c) Licensees who accept and retain residents with dementia shall be responsible for ensuring the following: (5) Each resident with dementia shall have an annual medical assessment as specified in Section 87458.... This requirement was not met as evidence by: Based on record review the Licensee did not comply with the section cited above in have physician reports for 2 residents which poses a potential health and safety risk for persons in care.the state’s words, verbatim · CDSS document, Dec 20, 2023

Plan of correction: Administrator agreed to obtain a current physician's report for R1 and R2 and submit copy to CCLD by POC date.

The state marks this report as 7 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.