306005622-3-1-2023-22-AS-SHAD-CPHW5B-20230301155851

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 306005622
Report Date: 03/01/2023
Date Signed: 03/01/2023 03:59:04 PM

Document Has Been Signed on 03/01/2023 03:59 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, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME:	ROSELLE CARE LLC		FACILITY NUMBER:	306005622
ADMINISTRATOR:	ROMEL BISDA		FACILITY TYPE:	740
ADDRESS:	226 HANNAH WAY		TELEPHONE:	(626) 617-8483
CITY:	PLACENTIA	STATE: CA	ZIP CODE:	92870
CAPACITY:	6	CENSUS: 6	DATE:	03/01/2023
TYPE OF VISIT:	Office	ANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Romel Bisda, Joseph Laxamana		TIME COMPLETED:	03:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On today’s date, Regional Manager (RM) Marina Stanic, Licensing Program Manager (LPM) Luz Adams, and Licensing Program Analyst (LPA) Sean Haddad conducted a virtual informal meeting via Microsoft Teams with Licensee and Administrator (LE) Romel Bisda and manager Joseph Laxamana. The purpose of the meeting was to follow up on the relationship between LE and manager Joseph Laxamana and the incident which occurred on 02/28/23 during which Joseph Laxamana and his partner Mary Joy Garcia arrived at the facility, were not trained or knowledgeable about the residents in care, claimed to be the new owners, attempted to terminate the current staff who were knowledgeable about the residents in care, the police were called, RM intervened via telephone, and LE agreed to keep the current staff in place and remove Joseph Laxamana and Mary Joy Garcia from the facility. During the meeting, the following items were discussed: • LE admitted the facts of the above incident which occurred on 02/28/23, apologized, and stated the events should not have occurred as they did. • Joseph Laxamana admitted the facts of the above incident which occurred on 02/28/23, apologized, and stated the events should not have occurred as they did. • LE and Joseph Laxamana explained that LE is in the process of selling the business to Joseph Laxamana, that Joseph Laxamana will work at the facility as an employee house manager until the sale is finalized, and that Joseph Laxamana will submit an application for change of ownership, but that LE is still the owner of and in control of the facility. • Non-transferability of the license. • Care and supervision for residents in care pending any changes in the facility. • The procedures for changes of ownership and adding a management company to the license. • The Business Purchase Agreement dated 02/06/2023 and Management Services Agreement dated 03/01/23.

SUPERVISOR'S NAME: Armando J Lucero	TELEPHONE: (714) 703-2840
LICENSING EVALUATOR NAME: Sean Haddad	TELEPHONE: (714) 335-7094
LICENSING EVALUATOR SIGNATURE:	DATE: 03/01/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2023

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: ROSELLE CARE LLC	FACILITY NUMBER: 306005622
	VISIT DATE: 03/01/2023

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During the meeting, the following was agreed upon:
• LE will look for an administrator to help with running the facility.
• Joseph Laxamana will work for LE as an employee house manager.
• LE will submit an updated LIC500 by close of business on 03/06/23 including Joseph Laxamana, Mary Joy Garcia, and all other staff, specifying their schedules.
• All staff will be properly background cleared and associated and properly trained.
• The facility will operate under its current license until any new license is issued.
• Joseph Laxamana will submit an application for change of ownership on or before 03/15/23.
• Another meeting will be held in approximately 3 weeks.
• LE will amend the Business Purchase Agreement dated 02/06/2023 and Management Services Agreement dated 03/01/23 as necessary to meet applicable requirements and submit the new versions prior to the next meeting.

An exit interview was conducted. This report will be emailed and an electronic email read receipt confirms receipt of the report. Facility representative agrees to sign the report and email it back to LPA.

SUPERVISOR'S NAME: Armando J Lucero	TELEPHONE: (714) 703-2840
LICENSING EVALUATOR NAME: Sean Haddad	TELEPHONE: (714) 335-7094
LICENSING EVALUATOR SIGNATURE:	DATE: 03/01/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2023

LIC809 (FAS) - (06/04)

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