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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306005299
Report Date: 07/30/2024
Date Signed: 07/30/2024 08:31:36 AM

Document Has Been Signed on 07/30/2024 08:31 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME:ROSEWOOD CARE HOMEFACILITY NUMBER:
306005299
ADMINISTRATOR/
DIRECTOR:		MALLARI, ANNAFACILITY TYPE:
740
ADDRESS:10821 VICKERS DRIVETELEPHONE:
(657) 667-0698
CITY:GARDEN GROVESTATE: CAZIP CODE:
92840
CAPACITY: 6CENSUS: 4DATE:
07/30/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
07:40 AM
MET WITH:Narciso De GuzmanTIME VISIT/
INSPECTION COMPLETED:
08:45 AM
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This unannounced POC inspection is being conducted by Licensing Program Analyst (LPA) Sean Haddad for the purpose of verifying correction of deficiencies issued during the Required – 1 Year Inspection conducted on July 25, 2024. LPA met with Staff #1 (S1) Narciso De Guzman and discussed the purpose of the inspection.

During the inspection, LPA and S1 toured the facility and observed the following:

Type A Violation cited under California Code of Regulations (CCR) Title 22, Section 87303(a) pertaining to smoke detectors has been CLEARED. During the inspection, LPA and S1 tested 7 smoke detectors throughout the facility and confirmed them to be functioning properly.

There were no deficiencies observed in the areas inspected. Based on the observations made during today’s inspection, no deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted and a copy of this report was discussed with and provided to facility representative.
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Sean Haddad
LICENSING EVALUATOR SIGNATURE: DATE: 07/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/30/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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