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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306004441
Report Date: 05/14/2025
Date Signed: 05/14/2025 11:28:21 AM

Unsubstantiated


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
01/02/2024 and conducted by Evaluator Alvaro Ramirez Jr.
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20240102095248
FACILITY NAME:ROSIE'S RESIDENTIAL CAREFACILITY NUMBER:
306004441
ADMINISTRATOR:JAIME RUALOFACILITY TYPE:
735
ADDRESS:1921 W.HALL AVENUETELEPHONE:
(714) 831-1335
CITY:SANTA ANASTATE: CAZIP CODE:
92704
CAPACITY:6CENSUS: 4DATE:
05/14/2025
UNANNOUNCEDTIME BEGAN:
08:41 AM
MET WITH:Karry Vallejo-AdministratorTIME COMPLETED:
11:41 AM
ALLEGATION(S):
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Staff are not meeting the minimum requirements required by licensing
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. conducted an unannounced visit to deliver findings on the above allegation received on January 02, 2024. LPA was greeted and granted entry into the facility and met with Administrator (AD) Karry Vallejo. LPA explained the reason for the visit.

This Department has investigated the complaint alleging staff are not meeting the minimum requirements required by licensing. Regarding the allegation the following was revealed: During the initial visit on January 08, 2024, LPA observed two staff members on duty for three clients in care. During the subsequent visit on May 14, 2025, LPA observed one staff member on duty for one client in care. During the investigation LPA reviewed documents including the Personnel Report (LIC500) dated January 2025. Per Personnel report on average there is one caregiver for the morning shift from 6:00am-3:00pm, two caregivers for the evening shift from 2:30pm-10:00pm and one caregiver for the night shift from 10:00pm-6:00am. Per California Code of Regulation under Day Staff-Client Ratio 85065.5 (a)(1) it states For Regional Center clients, staffing shall be maintained as specified by the Regional Center but no less than one direct care staff to three such clients.
CONTINUED ON LIC9099-C...
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2025
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 2
Control Number 22-AS-20240102095248
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: ROSIE'S RESIDENTIAL CARE
FACILITY NUMBER: 306004441
VISIT DATE: 05/14/2025
NARRATIVE
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Per California Code of Regulation under Personnel Requirements 80065 (f) it states all personnel shall be given on-the-job training or shall have related experience which provides knowledge of and skill...as appropriate to the job assigned and as evidenced by safe and effective job performance. During the course of the investigation LPA reviewed the staff trainings for Staff 1 (S1) and S2. Per staff trainings dated April 25, 2023, S1 completed six hours of consumer needs and services plan, eight hours of consumer personal rights, two hours of identification and reporting special incident and eights hours of Crisis Prevention Intervention (CPI) training. Per S2 trainings dated April 04, 2024, S2 has completed 16 hours of person centered thinking, one hour and a half of behavior issues in ARF, two hours of Infection Control, one hour of communication skills and two hours and a half of preparing for disasters.

Based on the information gathered during the investigation and review of documents obtained, LPA is unable to ascertain if the allegation occurred as reported due to conflicting information. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove or refute the alleged violation occurred; therefore, this allegation is deemed UNSUBSTANTIATED.

For today’s visit, there were no citations issued per Title 22, Division 6 of the California Code of Regulations.


LPA conducted an exit interview with AD Vallejo, and a copy of this report was provided to the facility.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2025
LIC9099 (FAS) - (06/04)
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