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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 191290817
Report Date: 11/06/2025
Date Signed: 11/06/2025 01:36:36 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/31/2025 and conducted by Evaluator Angela Panushkina
COMPLAINT CONTROL NUMBER: 31-AS-20251031110552
FACILITY NAME:ROSEWOOD HOMEFACILITY NUMBER:
191290817
ADMINISTRATOR:ROSEMARIE F. DECENARIOFACILITY TYPE:
740
ADDRESS:9645 FULLBRIGHT AVENUETELEPHONE:
(818) 993-9719
CITY:CHATSWORTHSTATE: CAZIP CODE:
91311
CAPACITY:6CENSUS: 5DATE:
11/06/2025
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Rosemarie Decenario, Administrator TIME COMPLETED:
01:15 PM
ALLEGATION(S):
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Illegal eviction
INVESTIGATION FINDINGS:
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At 9:00am, Licensing Program Analyst (LPA), Angela Panushkina conducted an unannounced visit in response to the above-mentioned allegation. LPA met with the Administrator and explained the reason for the visit.

At 9:05am, LPA requested resident and staff roster. At 9:10am, LPA requested copies of pertinent information which include, but not limited to Admission Agreement, Physician's Report, Appraisal Needs and Services Plan, Copy of an Eviction Letter, relevant to the investigation. At approximately 9:15am, LPA conducted a physical plant tour, to ensure health and safety of the residents are protected. Between
9:20am - 11:00am, LPA conducted an interview with the Administrator, three (3) staff, four (4) out of five (5) residents, who were able to communicate.

Continue on LIC9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Angela Panushkina
LICENSING EVALUATOR SIGNATURE:

DATE: 11/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 5
Control Number 31-AS-20251031110552
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: ROSEWOOD HOME
FACILITY NUMBER: 191290817
VISIT DATE: 11/06/2025
NARRATIVE
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Allegation: Illegal eviction

The information obtained during investigation indicated that facility Administrator did issue a written 30-day notice to the R1/R1's Responsible Person. During the review of eviction notice, LPA observed that the eviction notice indicated the issue date of 10/22/2025 and pro-rated charges until 11/22/2025. However, the written notice did not include the reason for the eviction, a list of referral agencies, the right of the resident or resident’s legal representative to contact the department and the contact information for the local Long-Term Care Ombudsman nor did it include specific language in reference to the filing of an unlawful detainer as per SB 781 and 1569.683 H&S. In addition, Community Care Licensing Office was never notified or received a copy of the eviction notice since it was issued. Based on the information obtained during the investigation the allegation is Substantiated.

Deficiency cited on LIC9099-D


Exit interview conducted, appeal rights explained and copy of this report signed and delivered.
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Angela Panushkina
LICENSING EVALUATOR SIGNATURE:

DATE: 11/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 31-AS-20251031110552
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: ROSEWOOD HOME
FACILITY NUMBER: 191290817
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/06/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/06/2025
Section Cited
HSC
1569.683(a)(2-4)
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Eviction notices... (a) In addition to complying with other applicable regulations... (2) Resources available to assist... (3) Information about the resident's right... (4) The following statement: "In order to evict a resident who..."
This requirement is not met as evidenced by:
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On 11/03/2025, the Administrator rescind in writing the previously issued written 30 day notice of eviction. Should the administrator wish to proceed with eviction a new written letter of eviction will be served in compliance with Title 22 Regulations. POC is cleared during todays visit.
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Based on interviews and record reviews, licensee did not comply with the section cited above, by issuing an anlawful eviction letter to R1, without providing a reason which poses a potential health and safety risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Angela Panushkina
LICENSING EVALUATOR SIGNATURE:

DATE: 11/06/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/31/2025 and conducted by Evaluator Angela Panushkina
COMPLAINT CONTROL NUMBER: 31-AS-20251031110552

FACILITY NAME:ROSEWOOD HOMEFACILITY NUMBER:
191290817
ADMINISTRATOR:ROSEMARIE F. DECENARIOFACILITY TYPE:
740
ADDRESS:9645 FULLBRIGHT AVENUETELEPHONE:
(818) 993-9719
CITY:CHATSWORTHSTATE: CAZIP CODE:
91311
CAPACITY:6CENSUS: 5DATE:
11/06/2025
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Rosemarie Decenario, Administrator TIME COMPLETED:
01:15 PM
ALLEGATION(S):
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Staff do not ensure that facility is maintained in a sanitary manner
Licensee retaliated against resident
INVESTIGATION FINDINGS:
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At 9:00am, Licensing Program Analyst (LPA), Angela Panushkina conducted an unannounced visit in response to the above-mentioned allegation. LPA met with the Administrator and explained the reason for the visit.

At 9:05am, LPA requested resident and staff roster. At 9:10am, LPA requested copies of pertinent information which include, but not limited to Admission Agreement, Physician's Report, Appraisal Needs and Services Plan, Copy of an Eviction Letter, relevant to the investigation. At approximately 9:15am, LPA conducted a physical plant tour, to ensure health and safety of the residents are protected. Between
9:20am - 11:00am, LPA conducted an interview with the Administrator, three (3) staff, four (4) out of five (5) residents, who were able to communicate.

Continue on LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Angela Panushkina
LICENSING EVALUATOR SIGNATURE:

DATE: 11/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 31-AS-20251031110552
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: ROSEWOOD HOME
FACILITY NUMBER: 191290817
VISIT DATE: 11/06/2025
NARRATIVE
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Allegation: Staff do not ensure that facility is maintained in a sanitary manner

It was alleged that R1 woke up in the middle of the night and there was urine on the bathroom floor. So, R1 set the box on top of it to prevent anyone from slipping and then waited in the kitchen for the staff to clean it up. To investigate this allegation LPA conducted an interview with the Administrator and was informed that on 09/20/25 R1 was prescribed a new medication and one of the side effects was “sleep disturbance”. The Administrator informed LPA that no urine was ever found on the floor and that the staff always make sure that the facility is clean. LPA conducted interviews with three (3) staff members, who corroborated the statement provided by the Administrator. Five (5) residents interviewed expressed no concern regarding this allegation. Additionally, R1 informed LPA that the staff is always keeping the facility clean and denied the above allegation. During today’s physical plant tour, LPA observed the kitchen, resident rooms, bathrooms and all common areas are clean and free from odor. Based on interviews and LPA observation, this allegation is deemed Unsubstantiated, at this time.

Allegation: Licensee retaliated against resident



The investigation included interviewing staff and residents. The Administrator and staff deny retaliating against any residents. LPA was informed that all residents are being treated with dignity and respect. Four (4) out of five (5) residents interviewed expressed no concern regarding this allegation. Therefore, based on interviews and information gathered during today’s visit, this allegation is deemed Unsubstantiated, at this time.

No deficiency issued.

Exit interview conducted and copy of this report signed and delivered.

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Angela Panushkina
LICENSING EVALUATOR SIGNATURE:

DATE: 11/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5