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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306003448
Report Date: 01/02/2026
Date Signed: 01/05/2026 08:27:37 AM

Unfounded


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/24/2025 and conducted by Evaluator Fred Arias
COMPLAINT CONTROL NUMBER: 22-AS-20251224150848
FACILITY NAME:FULLERTON ROSEWOOD ASSISTED LIVINGFACILITY NUMBER:
306003448
ADMINISTRATOR:JANE KIMFACILITY TYPE:
740
ADDRESS:411 E. COMMONWEALTH AVENUETELEPHONE:
(714) 441-0644
CITY:FULLERTONSTATE: CAZIP CODE:
92832
CAPACITY:99CENSUS: 55DATE:
01/02/2026
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Jane KimTIME COMPLETED:
04:52 PM
ALLEGATION(S):
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Staff yelled at a resident in care.
Staff illegally evicted a resident in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Fred Arias conducted an unannounced complaint visit to initiate an investigation into the above allegations. LPA was greeted and granted entry into the facility and explained the reason for the visit.

It was alleged staff yelled at resident in care and staff illegally evicted a resident in care. During the investigation, LPA conducted interviews with residents in care and staff. LPA reviewed records obtained.

The investigation determined as follows: Regarding the allegation staff yelled at resident in care, it was reported Administrator (AD) Jane Kim was yelling and humiliating Resident 1 (R1). LPA interview with R1 stated AD yelled at them most recently on October 22, 2025 but cannot articulate the details of the incident or recall which staff or residents witnessed the incident. Interviews with five out of five remaining residents stated they have never been yelled at by staff and have not witnessed staff yell at other residents.
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Fred Arias
LICENSING EVALUATOR SIGNATURE:

DATE: 01/02/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/02/2026
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 2
Control Number 22-AS-20251224150848
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: FULLERTON ROSEWOOD ASSISTED LIVING
FACILITY NUMBER: 306003448
VISIT DATE: 01/02/2026
NARRATIVE
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Interviews with three out of three staff stated they have never yelled at residents and have not witnessed any other staff yell at residents. Interview with the AD stated there was an incident a couple of years ago when R1 and R1’s family member were yelling at the AD and the AD had to speak over them to direct them to leave the office.

Regarding the allegation staff illegally evicted a resident in care, it was reported R1 was evicted from the facility. LPA interview with R1 stated they have not been served with an eviction notice recently but the facility did attempt to serve an eviction notice in July 2025 in which R1 refused to accept. LPA interview with AD stated an eviction notice was served to R1 in July 2025 due to R1’s aggressive behaviors towards other residents and a copy was sent to the Department for review. AD stated they decided not to follow through with the eviction and no further eviction attempts have been made since. LPA record review revealed R1 was served with an eviction notice on July 17, 2025 with a copy sent to the Department, R1, R1’s family, and the ombudsman. LPA verified the required language was included in the eviction notice.

Based on interviews and record review, LPA is unable to corroborate the allegations. Therefore, the allegations are deemed to be UNFOUNDED, meaning that the allegations were false, could not have happened and/or is without a reasonable basis.

An exit interview was conducted and a copy of the report was left with the facility representative.
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Fred Arias
LICENSING EVALUATOR SIGNATURE:

DATE: 01/02/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/02/2026
LIC9099 (FAS) - (06/04)
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