374604471-9-22-2026-18-AS-VMIN-DY6R2L-20260922123830

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 374604471
Report Date: 09/22/2026
Date Signed: 09/22/2026 12:39:09 PM

Document Has Been Signed on 09/22/2026 12:39 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, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME:	ROSEMARY WARMLANDS SENIOR CARE, INC.		FACILITY NUMBER:	374604471
ADMINISTRATOR/ DIRECTOR:	SKOGLIN, KRISTINE M.		FACILITY TYPE:	740
ADDRESS:	2350 WARMLANDS AVENUE		TELEPHONE:	(619) 871-0285
CITY:	VISTA	STATE: CA	ZIP CODE:	92084
CAPACITY: 6		CENSUS: 6	DATE:	09/22/2026
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	10:10 AM
MET WITH:	ADMINISTRATOR< KRISTINE M. SKOGLIN		TIME VISIT/ INSPECTION COMPLETED:	12:48 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 September 22, 2026, Licensing Program Analyst (LPA), Venus Mixson arrived at the facility unannounced and met with Administrator, Kristine Skoglin. The annual visit was conducted with the utilization of the Care Tools. The facility file review was conducted at the Regional Office, and additional records were requested and reviewed on site. The facility is licensed for six Elderly Adult Residents and is currently operating within the scope of their license.
LPA toured the facility, along with Administrator, and made observations pertaining to the annual visit. The facility was inspected inside and outside there were no obstructions or debris to the indoor or outdoor passageways at the time of this visit. Facility is a two-story home located at 2350 Warmlands Ave, Vista CA. 92084.The facility phone number is (619) 871-0285 and it is operable. LPA observed each residents’ bedrooms, and each was equipped with required furniture as per Title 22. The facility bathrooms were observed to be clean and free of unpleasant odors. Hot water temperature tested within regulations, and bathrooms were clean. The facility is equipped with operating smoke detectors, carbon monoxide alarms, and fire extinguishers. LPA observed required postings and cleaning supplies and sharp items were kept locked and inaccessible to the residents in care currently. The designated storage space for facility files was locked and inaccessible to others. Medications were locked and inaccessible to residents in care, and there was a sufficient supply. Overall, the facility is clean, furniture is in good condition, and the home temperature was within regulations for the season. Cooling system and other appliances were operable at the time of this visit. Non-perishable and perishable food supply was sufficient per regulations, and there are a variety of food types available for residents. Dishes and utensils were in sufficient supply and stored properly, and sharp items were locked. Disaster drills are conducted and logged, First and is current, along with TB tests.

Facility has sufficient staff, currently three staff and six of six residents were observed engaging with caregivers.

There were no Title 22, Division 6 Regulation violations observed or cited during today’s visit.

An exit interview was conducted, and a copy of this report was discussed and given to Administrator, Kristine M. Skoglin

Jazmond D Harris
Venus Mixson
	DATE: 09/22/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2026

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 2

California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

Page: 2 of 2