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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 150400536
Report Date: 03/21/2022
Date Signed: 03/21/2022 05:25:42 PM


Document Has Been Signed on 03/21/2022 05:25 PM - 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, 1314 E SHAW AVE
FRESNO, CA 93710



FACILITY NAME:ROSEWOOD RETIREMENT COMMUNITYFACILITY NUMBER:
150400536
ADMINISTRATOR:BALABAN, ROCHELLEFACILITY TYPE:
741
ADDRESS:1301 NEW STINE ROADTELEPHONE:
(661) 834-0620
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93309
CAPACITY:220CENSUS: 151DATE:
03/21/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Cille Caldwell, Director of Assisted Living
Rochelle Balaban, Administrator		TIME COMPLETED:
12:30 PM
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On 3/21/22 at 9:00 AM, Licensing Program Analyst (LPA) Malia Thao arrived unannounced to conduct an Annual inspection. LPA explained reason for inspection and met with Director of Assisted Living Cille Caldwell and Administrator Rochelle Balaban. COVID-19 guidelines are in place. Visitor log-in/temperature check was observed upon entry. Facility has one entrance/exit point for residents and visitors. Screening kiosks are used by visitors and staff.

LPA toured facility and observed no obstructions or fire clearance issues. Hand sanitizer was readily available to residents and visitors. Social distancing is maintained in the common and dining areas. Facility has medication room and uses med carts, where at least 30-day supply of medication was observed. Cleaning and PPE supplies were checked. A sample of staff records were reviewed for good health and infection control training. Facility staff was observed with masks on. Resident files are updated for emergency contact information regularly. Administrator certification is current.

The following updated forms are to be submitted to CCL within 2 weeks:

LIC500, LIC610E, proof of liability insurance

No deficiencies cited during this inspection.

Exit interview conducted. Due to COVID-19 precautions, a copy of this report was emailed to Administrator with Read receipt to confirm receipt of this report.
SUPERVISOR'S NAME: Andy XiongTELEPHONE: (559) 650-7904
LICENSING EVALUATOR NAME: Malia ThaoTELEPHONE: (559) 650-7931
LICENSING EVALUATOR SIGNATURE:
DATE: 03/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/21/2022
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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