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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 435200967
Report Date: 08/12/2020
Date Signed: 09/01/2020 10:02:34 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131
FACILITY NAME:ROSE GARDEN COURTFACILITY NUMBER:
435200967
ADMINISTRATOR:ROSETE, LILETTEFACILITY TYPE:
740
ADDRESS:958 VERMONT STREETTELEPHONE:
(408) 247-0815
CITY:SAN JOSESTATE: CAZIP CODE:
95126
CAPACITY:30CENSUS: 18DATE:
08/12/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:03 PM
MET WITH:Michael RoseteTIME COMPLETED:
01:18 PM
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Licensing Program Analyst (LPA) Yatfai Eric Ng conducted an unannounced case management - other tele-visit. Due to current Coronavirus pandemic (COVID-19) situation, LPA virtually met with the Licensee Michael Rosete via telephone.

The purpose of the visit was to gather additional information as Community Care Licensing Department received a concern from the public that the facility might evict a resident if the resident refuses to sign the agreement on visitation during COVID-19.

Licensee stated the facility would not evict a resident due to the visitation. Licensee stated the facility has worked with many families and had different arrangements and safety precautions implemented so that the families can visit the residents.

Licensee stated he understood the elements before issuing any eviction notice to a resident. The facility had not issued any eviction notice to the residents due to the COVID-19.

An advisory note (LIC 9102) was issued to the facility. No deficiency was cited during visit.

This report was emailed to Licensee for reference and to obtain a signature.
SUPERVISOR'S NAME: Sarah YipTELEPHONE: (408) 324-2131
LICENSING EVALUATOR NAME: Yatfai NgTELEPHONE: (559) 410-0327
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2020
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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