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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 150400536
Report Date: 08/29/2023
Date Signed: 08/29/2023 11:44:05 AM


Document Has Been Signed on 08/29/2023 11:44 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, 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: DATE:
08/29/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:32 AM
MET WITH:Administrator Rochelle BalabanTIME COMPLETED:
12:00 PM
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Licensing Program Analyst (LPA) Shawna Doucette met with Administrator Rochelle Balaban to conduct a case management visit regarding a Decision and Order notice from the Caregiver Background Check Bureau (CBCB) requiring immediate action.

The notice required staff #1 to be immediately removed from the facility if present. Per the Administrator, the staff was not employed by the facility.

A copy of this report was provided.
SUPERVISOR'S NAME: Sergiy PidgirnyTELEPHONE: (559) 246-0610
LICENSING EVALUATOR NAME: Shawna DoucetteTELEPHONE: (559) 580-4595
LICENSING EVALUATOR SIGNATURE:
DATE: 08/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/29/2023
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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