Routine inspection·March 11, 2025

Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced visit to Rosehaven III Care Home. The purpose of today’s visit was to conduct the Annual Required inspection. LPA was allowed entry into the home and explained the reason for the visit. Facility is licensed for 6 non-ambulatory residents. Facility has an approved hospice waiver for 3 residents and the home currently has 4 residents. There are no residents on hospice during today's visit and one resident receiving home health care service. Administrator Tina Shalaby has a current administrator certificate expiring on 05/21/2025. LPA Lyman along with Caregiver Annie Macaraeg toured the facility at 7:56 AM. Administrator Tina Shalaby arrived during the visit. LPA toured the physical plant, checked food service, reviewed records and the first aid kit. Facility appears to be clean, safe, and sanitary. The home consists of four resident bedrooms, two resident restrooms, common restroom, one staff room, living room, dining room, and kitchen. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. LPA observed three residents with a half bed rails. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure and shower was free of mold/mildew. Water temperature measured between 110.6 and 116.2 degrees F in all facility restrooms. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked at time of visit. Common areas were clean and clear of hazards, doorways were free of obstructions. First aid kit had all the required elements including tweezers, thermometer, and scissors. The entry door into the garage is secured. LPA observed a locked storage area for cleaning supplies under the kitchen sink. Kitchen was inspected. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. LPA observed sharps locked in a kitchen drawer. Smoke detectors and Carbon Monoxide detectors are hardwired and tested operational during today's visit. Fire extinguishers are fully charged. Kitchen appliances are operational during today's visit. LPA toured the outside grounds and there is ample shaded seating for residents. Exit gates are unlocked. LPA observed ample emergency food and water supply. LPA reviewed the emergency disaster plan during the visit. Plan is thorough and complete. Facility provided documentation of last fire drill conducted on 09/15/2024. Facility provides activities in the form of exercise and music therapy. CONT ON LIC809-C DATED 03/11/2025 At 9:00 AM, LPA reviewed four resident files and three staff files. Resident files contained required documents including admission agreements, current physician reports and resident appraisals. Resident 4 (R4) does not have a medical assessment in the file. Staff files did not contain proof of training. Two out of three staff do not have association to the facility. At 9:30 AM, LPA reviewed medication storage and administration. Medications are stored in a locked cabinet and are audited monthly by staff. Medications are being administered per physician order. Based on the observations made during today's visit, the following violations are being cited per California Code of Regulations, Title 22, Division 6, Chapter 8. An exit interview was conducted and a copy of this report as well as appeal rights were discussed and provided with facility representative.