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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604471
Report Date: 02/14/2022
Date Signed: 02/14/2022 03:15:11 PM


Document Has Been Signed on 02/14/2022 03:15 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, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108



FACILITY NAME:ROSEMARY WARMLANDS SENIOR CARE, INC.FACILITY NUMBER:
374604471
ADMINISTRATOR:SKOGLIN, KRISTINE M.FACILITY TYPE:
740
ADDRESS:2350 WARMLANDS AVENUETELEPHONE:
(619) 871-0285
CITY:VISTASTATE: CAZIP CODE:
92084
CAPACITY:6CENSUS: 6DATE:
02/14/2022
TYPE OF VISIT:Post LicensingUNANNOUNCEDTIME BEGAN:
10:27 AM
MET WITH:Kristine Skoglin, LicenseeTIME COMPLETED:
02:05 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
Licensing Program Analyst (LPA) Carmen Lopez conducted an unannounced visit to conduct a post-licensing inspection to ensure that the facility is operating in compliance with California Code of Regulations, Title 22, Division 6. LPA introduced herself, disclosed the purpose of the visit and was granted entry into the facility by Melodia Caluza, designated Managing Care staff. Licensee Kristine Skoglin later joined the inspection.

A tour of the facility was conducted inside and out. LPA conducted a general overall inspection, which included, but was not limited to, infection control protocols.

During today's inspection LPA observations include the following: Symptom screening procedures for staff, residents and visitors; posted signs regarding visitor policy, promoting hand washing, cough and sneeze etiquette and other infection control procedures; testing plan and procedures was discussed; plans for containing infections, PPE supplies procedures and training; and disinfection procedures.

All indoor and outdoor passageways were free from obstructions. The facility’s indoor temperature was 74 degrees Fahrenheit. No pools were observed. A fountain was observed with rocks inside the fountain. According to Licensee Skoglin there are no firearms or ammunition stored in the facility. Cleaning supplies and toxins were locked in an inaccessible cabinet to the residents. LPA toured resident bedrooms. The rooms had the required furnishings and sufficient lighting. Licensee provided the residents with clean linens, in good repair, and sufficient hygiene products for personal use. The facility had functioning carbon monoxide detectors and smoke detectors that met statutory regulations. A one week’s non-perishable food supply is maintained on the property. Perishable food supply is maintained for two days. All food was properly stored and made available to residents. Medications were observed to be labeled and in a locked a cabinet that is inaccessible to residents.
SUPERVISOR'S NAME: Rebecca HedgecockTELEPHONE: (619) 767-2329
LICENSING EVALUATOR NAME: Carmen LopezTELEPHONE: (619) 314-0757
LICENSING EVALUATOR SIGNATURE:
DATE: 02/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/14/2022
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 5


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME: ROSEMARY WARMLANDS SENIOR CARE, INC.
FACILITY NUMBER: 374604471
VISIT DATE: 02/14/2022
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
26
27
28
29
30
31
32
Based on today’s inspection, no deficiencies were observed. An exit interview was conducted with Licensee Skogin. A copy of this report, along with the Administrator Rights (01/2016) was emailed to Licensee Skoglin at the conclusion of the visit. LPA requested Licensee to send LPA an electronic message reply confirming receipt of these documents.
SUPERVISOR'S NAME: Rebecca HedgecockTELEPHONE: (619) 767-2329
LICENSING EVALUATOR NAME: Carmen LopezTELEPHONE: (619) 314-0757
LICENSING EVALUATOR SIGNATURE:

DATE: 02/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2022
LIC809 (FAS) - (06/04)
Page: 2 of 5