374603871-2-25-2026-18-AS-RORN-DRUMQR-20260304084908

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374603871
Report Date: 02/25/2026
Date Signed: 02/25/2026 01:21:23 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/22/2023 and conducted by Evaluator Antonine Richard

COMPLAINT CONTROL NUMBER: 18-AS-20230922144014

FACILITY NAME:	ROSE GARDEN		FACILITY NUMBER:	374603871
ADMINISTRATOR:	CORPUZ, ROLANDO		FACILITY TYPE:	740
ADDRESS:	1266 PLEIADES DR		TELEPHONE:	(760) 659-6397
CITY:	VISTA	STATE: CA	ZIP CODE:	92084
CAPACITY:	15	CENSUS: 14	DATE:	02/25/2026
		UNANNOUNCED	TIME BEGAN:	01:06 PM
MET WITH:	Corpuz Rolando		TIME COMPLETED:	01:07 PM

ALLEGATION(S):

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Facility is in disrepair.
Staff did not keep the facility free from cockroaches.
Staff did not keep the facility free of mold.

INVESTIGATION FINDINGS:

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On February 25, 2026, Licensing Program Analyst (LPA) Antonine Richard conducted a subsequent complaint visit to the facility regarding the above allegations. LPA met with the Administrator (A1), Rolando Corpuz, and explained the purpose of the visit. LPA, along with staff, toured the facility.

The investigation included the following: On February 19, 2026, LPA Richard reviewed and obtained the residents' roster dated 11/29/2025, staff roster dated 11/29/2025, and thirteen residents' files (R1-R13). These files included Admission Agreements, Physician Reports, Needs and Service Plans, and Medication Administration Records (MAR). The LPA also obtained two months of invoices from Lloyd Pest Control, dated 01/20, 26, and 02/17/2026. On the same day, the LPA interviewed the Administrator (A1), Rolando Corpuz, three staff members (S1-S3), and six residents (R1-R6).

Report continued on LIC9099C.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Antonine Richard
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:	DATE: 02/25/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 18-AS-20230922144014

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: ROSE GARDEN	FACILITY NUMBER: 374603871
	VISIT DATE: 02/25/2026

NARRATIVE

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Allegation #1: Facility is in disrepair.

The complaint alleged that the facility has deferred maintenance issues, such as leaks, dry rot, and kitchen cabinets that are completely dry rotted due to unrepaired leaks, which they refuse to repair. On February 19, 2026, LPA Richard interviewed the Administrator (A1), who denied the allegation and stated that the facility has maintenance staff who assist with any repairs needed. On February 19, 2026, LPA interviewed three staff members #1-3 (S1-S3), who denied that the facility is in disrepair. They also said maintenance is always available to address any complaints from residents or staff. On February 19, 2026, LPA interviewed six residents #1-6 (R1-R6), who denied that the facility or their bedrooms are in disrepair. They also said that when something is broken, the facility fixes it right away. On February 19, 2026, LPA observed that the facility is in good condition, with no leaks; the kitchen cabinets are in good shape and show no dry rot.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation (s) did or did not occur, therefore the allegation is unsubstantiated.

Allegation #2: Staff did not keep the facility free from cockroaches.

The complaint alleged that the facility's appliances were infested with cockroaches. On February 19, 2026, LPA Richard interviewed the Administrator (A1), who denied the allegation and stated that the facility has a pest control company, Lloyd Pest Control, that visits twice a month. On the same day, LPA interviewed three staff members, #1-3 (S1-S3), who also denied the allegation and mentioned that the facility has a contractor who services the facility and residents' rooms. Additionally, six residents, #1-6 (R1-R6), were interviewed, and they all denied seeing any cockroaches inside the facility or in their rooms. Also on February 19, 2026, LPA reviewed the facility's records, which showed two months of invoices from Lloyd Pest Control (dated 01/26/26 and 02/17/26). During a visit to the kitchen on February 19, 2026, LPA did not observe any cockroaches.

SUPERVISORS NAME: Antonine Richard
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:	DATE: 02/25/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 18-AS-20230922144014

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: ROSE GARDEN	FACILITY NUMBER: 374603871
	VISIT DATE: 02/25/2026

NARRATIVE

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Allegation #3: Staff did not keep the facility free of mold.

The complaint alleged that black mold was growing behind the stove and under the sink. On February 19, 2026, LPA Richard interviewed the Administrator (A1), who denied the allegation and stated that the facility has maintenance personnel who repair leaks, mold, and tears. On the same day, LPA interviewed three staff members, #1-3 (S1-S3), who also denied the allegation and mentioned that the facility has a maintenance staff member who services the facility and residents' rooms. Additionally, six residents, #1-6 (R1-R6), were interviewed, and they all denied observing any mold inside the facility. Also, on February 19, 2026, during a kitchen visit, LPA did not observe any mold behind the stove or under the sink.

No deficiencies were cited.

An exit interview was conducted. A copy of the report was provided to the administrator, Corpuz Ronaldo.

SUPERVISORS NAME: Antonine Richard
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:	DATE: 02/25/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2026

LIC9099 (FAS) - (06/04)

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