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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 415600883
Report Date: 06/21/2024
Date Signed: 06/21/2024 02:17:18 PM

Document Has Been Signed on 06/21/2024 02:17 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
SAN BRUNO RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:ROSEL'S HOMEFACILITY NUMBER:
415600883
ADMINISTRATOR/
DIRECTOR:		ROMAR RAQUINIOFACILITY TYPE:
735
ADDRESS:2033 OREGON AVENUETELEPHONE:
(650) 387-9488
CITY:REDWOOD CITYSTATE: CAZIP CODE:
94061
CAPACITY: 4CENSUS: 4DATE:
06/21/2024
TYPE OF VISIT:OfficeUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Licensees - Selene Cruz and Romar RaquinoTIME VISIT/
INSPECTION COMPLETED:
02:30 PM
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On 06/21/2024, San Bruno Regional Office conducted a non-compliance conference meeting with licensee members Selene Cruz and Romar Raquino. Romar is also the administrator of the facility. Present in the meeting is Regional Manager Vivien Helbling, Licensing Program Managers April Cowan, Andrea Medlin, and Licensing Program Analyst Jaime Vado.
 
During this non-compliance meeting, the following violation was discussed, Personal Rights, Training Requirements, Administrator Qualifications and Duties, Health Related Services, Personnel Requirements, and Accountability.

During this meeting, it was discussed, Licensee will receive more frequent monitoring inspection visits to ensure compliance with this compliance plan and Title 22 Regulations for 2 years. Licensee was provided the link below for resources and guidance to improve facility operations: 
https://www.cdss.ca.gov/inforesources/community-care/resource-guide-for-providers

Report is reviewed with Selene and Romar and a copy is provided.

Additional civil penalties may be assessed.
SUPERVISORS NAME: April Cowan
LICENSING EVALUATOR NAME: Jaime Vado
LICENSING EVALUATOR SIGNATURE: DATE: 06/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/21/2024
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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