Rovelo Senior Home

Allegation investigated: Resident sustained unexplained bruises.

On 03/12/2026, Licensing Program Analyst (LPA) V. Gorban arrived unannounced delivering findings to complaint investigation. LPA explained the purpose of the visit to facility lead staff Rosalind and was allowed entry. During the course of the investigation, LPA conducted a facility tour, conducted interviews, and reviewed records. Allegation: Resident sustained unexplained bruises. Based on interviews and records review, R1 did not have concerns although bruises easily due to medication prescribed. 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. Exit interview conducted, report signed and copy of this report provided for facility records. Unsubstantiatedthe state’s words, verbatim · CDSS document, Mar 25, 2026 · control 24-AS-20260220164810

Type of visit: Prelicensing

On 09/25/25, Licensing Program Analyst (LPA) V Gorban arrived at the facility for an announced Pre-licensing visit. LPA was greeted by Licensee/Administrator and was allowed entry in the facility. Upon entry, LPA observed the required postings to be present. LPA conducted the inspection using the Inspection Tool. LPA toured the facility inside and out with Licensee/Administrator. The facility is observed to be a 5 bedroom and 2-bathroom home. Fire clearance was granted for a total of 6 capacity. 4 Non-Ambulatory, 2 Bedridden. (Bedroom #1 is approved for 2 Bedridden, Bedroom #2 is approved for 1 Non-Ambulatory, Bedroom #3 is approved for 1 Non-ambulatory and Bedroom #4 is approved for 1 Non-ambulatory, and bedroom#5 approved for 1 non-ambulatory resident.). Facility temperature is set to 76 degrees. Common areas were furnished and had adequate seating and lighting available. Bedrooms were observed to have required furnishings and lighting. Mattresses were observed to be new and in good condition. LPA observed an extra supply of linens located in the hallway closet. A supply of personal hygiene and grooming products were observed. Kitchen was toured and observed to have dishes, plate, and utensils. LPAs observed a 2-day supply of perishable foods and a 7-day supply of non-perishable foods. Knives were observed to be locked and secure in the hobby room located off the living room. Cleaning supplies and chemicals were observed to be in a locked in the garage. LPA observed a locked closet in the common room and identified as the medication cabinet. Closet has a lock and will be inaccessible to residents in care. First aid kit was observed to be new and contained all required items. A fire extinguisher was observed and has a service date of 08/19/2025. Smoke detectors and carbon monoxide detectors were observed to be operational during this inspection. Outside of facility toured. Exits were open and free of obstructions. LPA observed side gate to be unlocked and self-latching. Facility's phone number is (209) 325-4444. Pre-Licensing is complete and this facility has no deficiencies.the state’s words, verbatim · CDSS document, Sep 26, 2025

Type of visit: Office

COMP II by CAB successfully completed Method: Phone Call at CAB Applicant/administrator participated in COMP II at CAB telephone call with analyst at CAB. Identification of the applicant and administrator was verified by presenting photo ID via phone. 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 7. 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, Jul 15, 2025