<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 347003896
Report Date: 11/03/2021
Date Signed: 11/03/2021 10:56:54 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME:ROSEMONT SENIOR CARE HOMEFACILITY NUMBER:
347003896
ADMINISTRATOR:BUDEAN, LIDIAFACILITY TYPE:
740
ADDRESS:3348 HUNTSMAN DRIVETELEPHONE:
(916) 364-7673
CITY:SACRAMENTOSTATE: CAZIP CODE:
95826
CAPACITY:6CENSUS: 0DATE:
11/03/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Property ownerTIME COMPLETED:
11:15 AM
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 11/3/21 at 10:30am Licensing Program Analyst (LPA) Kevin Gould arrived at Rosemont Senior Care Home for the purpose of confirming the closure of the facility.

LPA observed the facility has been closed and the facility is no longer offering RCFE services at this location. LPA spoke with the new owners of the home who confirmed they purchased the home in April 2021 and allowed LPA in the home to confirm they are no longer offering services. LPA observed no facility activities in the home and observed several children in the home which the owner states as the reason for purchasing the home as they have 7 children.

LPA also observed mail outside of the home addressed to the licensee with notes to the postal service that that licensee no longer lives at the home.

Exit interview was conducted and a copy of this report was mailed to the licensee for signature.
SUPERVISOR'S NAME: Czarrina A Camilon-LeeTELEPHONE: (916) 263-4723
LICENSING EVALUATOR NAME: Kevin GouldTELEPHONE: (619) 672-5924
LICENSING EVALUATOR SIGNATURE:

DATE: 11/03/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 1