Vista Rosa Elder Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) De Leon arrived at 1:31 pm to conduct a 1 year annual visit to the facility above. LPA met with Administrator, Rachelle Tellez 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. The facility has 19 resident bedrooms with on suite bathrooms, 2 guest bathrooms and 1 staff bathroom. LPA was authorized to enter and inspect facility. The facility has smoke and carbon monoxide detectors dual and hard wired with a sprinkler system. 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 non-skid mats or 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. 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. Continued 809-C 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 25. The fire clearance is granted for 25 non-Ambulatory, 25 of which may be bedridden. Hospice is approved for 8. Staffing: LPA will return to complete this portion of the annual visit. Personnel Records & Training: LPA will return to complete this portion of the annual visit. Residents Rights & Information: LPA will return to complete this portion of the annual visit. Resident Records & Incident Reports: LPA will return to complete this portion of the annual visit. 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 and cold water machine the hot is designated with red and a hot sticker in red to notify of hot water. The kitchen door is key coded for entry into the commercial kitchen. 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 all 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 2 resident on Oxygen and signs are posted. The facility has 1 resident on hospice services, The facility currently has 8 residents on home health services. Hospice and Home Health Plans are kept up to date and on file at the facility. Exit interview conducted, no deficiency cited and copy of report printed for Administrator.the state’s words, verbatim · CDSS document, Apr 10, 2026

Type of visit: Case Management - Incident

Licensing Program Analyst (LPA) De Leon conducted a Case Management- Incident Visit to the facility above. LPA met with Back up Administrator Jessica Bailey and explained the purpose of the visit. Community Care Licensing (CCL) received a self reported incident report from the facility dated 02/01/2026 for Resident (R1). Administrator Rachelle Tellez contacted LPA De Leon to report by telephone and followed up with a written incident report to CCL. R1 was able to elope from the facility and sustained a scrape to R1’s elbow and no other injuries were found.. R1 was located and brought back to the facility by staff. R1's LIC. 602 Physicians report stated that R1 can not leave the facility unassisted. This is the first time R1 had displayed exit seeking behaviors. CCL received another self reported incident report on 02/03/2026 for Resident 2 (R2). R2 was able to get out of the building and proceeded to go down the 2nd story stairwell when a nearby neighbor seen R2 contacted the facility staff and staff were able to redirect R2 back in the building. R2 did not elope off the property. The door alarm did go off, the two staff were on duty and Staff 1 (S1) was with another resident and Staff 2 (S2) had just gone in the elevator and did not hear the alarm go off. This is the first time R2 had displayed exiting seeking behaviors. On 02/01/2026 and 02/03/2026 by review of the staff schedules the facility was fully staffed on those days during those elopements.The facility does have alarmed exiting doors and the alarm was functioning properly. Exit interview conducted, deficiency cited, Civil Penalty assessed, copy of report and appeal rights printed for Administrator.the state’s words, verbatim · CDSS document, Feb 27, 2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87705(d) · Plan of correction due date: Mar 2, 2026

(d) The licensee shall ensure that the facility has an auditory device or other staff alert feature to monitor exits on exterior doors and perimeter fence gates accessible to those residents who may be at risk for elopement, as defined in Section 87101, Definitions. This requirement was not met evidenced by: Based on records the Licensee did not comply with the regulation above, R1 was able to elope from the facility property and sustained a scrape on R1's elbow which possess a immediate health, safety and personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Feb 27, 2026

Plan of correction: Administrator agreed to write Letter of understanding regulation 87705, train staff in regulation and Facility policy on elopements and provide letter and proof of training to CCL.

Type of visit: Case Management - Incident

Licensing Program Analyst (LPA) De Leon conducted a case management-incident visit to the facility above. LPA met with back up Administrator Jessica Bailey and explained the purpose of the visit. Community Care Licensing (CCL) received a self reported incident report from the facility dated 12/10/2025. LPA De Leon received a telephone call from Administrator Rachelle Tellez on 12/10/2025 reporting resident 1(R1) and resident 2 (R2) had an incident where a personal trainer contracted by resident 2(R2) was involved in kicking R1's walker back so R1 could not push R1's walker into R2's wheelchair. On 02/05/2026 Administrator Rachelle Tellez sent LPA De Leon a copy of the video surveillance she had sent to LTCO of the incident. LPA De Leon reviewed the video surveillance and it was found that the personal trainer of R2 was left alone with both R1 and R2 in a common area of the facility. The personal trainer as a contractor hired by R2 was not able to be left alone with R1 and no staffing of the facility was present at the exact time of the incident, staffing immediately came into the common area as soon as the incident had ended. The personal trainer that was contracted by R2 was not on the facility approved Guardian roster for CCL and therefore should not have been left alone with R1 in care without being associated to the facility Guardian roster. Exit interview conducted, deficiency cited, civil penalty assessed, copy of report and appeal rights printed for Administrator.the state’s words, verbatim · CDSS document, Feb 27, 2026

From the deficiency page — Deficiency type: Type A · Section cited: HSC 1569.17(b)(2)(C) · Plan of correction due date: Mar 2, 2026

(b)...(2) The following persons are exempt from requirements applicable under paragraph (1):(C) A third-party contractor retained by the facility if the contractor is not left alone with clients in care. This requirement was not met as evidenced by: Based on video surveillance the Licenesee did not comply witht the regulation above the personal trianer higher by R2 did not have a clearance to be left alone with R1 which possess an immediate health and saefty risk for residnets in care.the state’s words, verbatim · CDSS document, Feb 27, 2026

Plan of correction: Administrator agreed to read and have a full undersading of H&S code 1569.17 and trian staff on the H&S code, provide proof of trianing to CCL.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) De Leon arrived at 9:55 am to conduct a 1 year annual visit to the facility above. LPA met with Administrator, Rachelle Tellez 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. The facility has 19 resident bedrooms with ensuite bathrooms, 2 guest bathrooms and 1 staff bathroom. LPA was authorized to enter and inspect facility. The facility has smoke and carbon monoxide detectors dual and 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 non-skid mats or 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. 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. Continued 809-C 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 25. The fire clearance is granted for 25 non-Ambulatory, 25 of which may be bedridden. Hospice is approved for 8. Staffing: The facility currently employes 13 full time staff, and 2 Administrators. Staff records are kept confidential. Files 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. Staff have annual training completed for 20 plus hours from 06/2024-05/2025. 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 and cold water machine the hot is designated with red and a hot sticker in red to notify of hot water. 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 1 resident on PRN Oxygen and sign is posted. The facility has 3 residents on hospice services, The facility currently has 7 residents on home health services. Hospice and Home Health Plans are kept up to date and on file at the facility. Exit interview conducted and copy of report printed for Administrator.the state’s words, verbatim · CDSS document, May 23, 2025

Type of visit: Annual/Random

Licensing Program Analyst (LPA) Miller arrived at 9:00 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 are visible in the guest bathrooms. 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). All trash cans and wastebaskets have tight fitting covers. Physical Plant & Environment Safety: The fire extinguisher was last charged and inspected on May 21, 2024. The facility has 19 resident bedrooms with ensuite bathrooms and 2 guest bathrooms. LPA was authorized to enter and inspect facility. The facility has smoke and carbon monoxide detectors that were last inspected on January 22, 2024 and a report was provided. 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 non-skid mats or 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 land are locked in storage units. The facility has sufficient space inside and outside for activities and visiting. The facility has a patio for client use. The facility has telephone and internet service for resident use. Continued 809-C 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, 2025. The facility is approved for a capacity of 25. The fire clearance is granted for 25 non-Ambulatory, 25 of which may be bedridden. Hospice is approved for 8. Staffing: The facility currently employes 14 full time staff, and 2 Administrators. Staff records are kept confidential. Files reviewed had current 1st Aid/CPR, Personnel Records/Application, Health screening with TB results, Criminal Record statements, and Fingerprint clearance and education requirements. It was determined that Staff 1 did not have a background clearance completed. Per the Guardian website, on December 26, 2022, and April 11, 2024, notices of Incomplete Fingerprint Submission Reminders were sent to Casa Rosa Elder Care email of record. The December 26, 2022, notice stated, “that the fingerprints required to complete your background check for CASA ROSA ELDER CARE - 405801779 have not yet been received. If you do not complete your fingerprints by 12/30/2022 your background check application request will be closed. An April 11, 2024, notice stated that if you do not complete your fingerprints by April 22, 2024, your background check application request will be closed. As a result, the agency will be notified that you have failed to complete this requirement.” As such, Staff 1 was not cleared and Staff 1 was required to leave the premises, until fingerprint clearance has been completed.Administrator disputes that the above correspondence was received by facility. Administrator noted that the facility received documentation that Staff 1 had a clearance with DOJ, but this document only indicates DOJ clearance was received and not the complete CCL clearance, which also reviews FBI records. Although, Staff 1 was associated to facility Staff 1 was not cleared to work and had a status of "in progess". Administrator Certificate is currently pending renewal. Personnel Records & Training: The facility keeps confidential files for each staff member. Staff have annual training completed for various subjects/topics and hours for 2023 and 2024. 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, Emergency and ID forms. Continued 809-C 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. 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. 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. The facility currently has residents receiving Home Health services. Exit interview conducted citation issued and copy of report and appeal rights printed for Administrator.the state’s words, verbatim · CDSS document, Sep 11, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Miller 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. LPA took a tour of the interior of the facility. LPA will need further time to complete the annual visit and will return at a later date. Exit interview conducted and copy of report printed for Administrator.the state’s words, verbatim · CDSS document, Apr 10, 2024