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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 435200967
Report Date: 05/14/2025
Date Signed: 07/15/2025 10:20:55 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131
This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/05/2025 and conducted by Evaluator Santino Fortes
COMPLAINT CONTROL NUMBER: 26-AS-20250205155405
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: 12DATE:
05/14/2025
UNANNOUNCEDTIME BEGAN:
03:20 PM
MET WITH:LIcensee - Michael RoseteTIME COMPLETED:
04:40 PM
ALLEGATION(S):
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Staff did not ensure that facility is free from insects or rodents.
INVESTIGATION FINDINGS:
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THIS IS AN AMENDED REPORT. On 05/14/2025, Licensing Program Analyst (LPA) Santino Fortes arrived to the facility unannounced to deliver the complaint investigation findings for the above allegation. LPA met with Licensee, Michael Roste.

On 2/5/2025 the Department received a complaint with the above allegation. On 2/14/2025 the Department conducted the initial unannounced complaint investigation. LPA interviewed staff and residents. LPA conducted a facility file review.

Based on observations, LPA inspected the facility inside and out to include resident rooms, common rooms, kitchen and food pantry. LPA did not observe any insects or pests. LPA interviewed 3 out of 3 staff (S1, S2, S3) who stated that they have not observed insects/pests in the facility and see exterminators periodically fumigating the facility. 5 out of 6 residents (R2, R3, R4, R5, R6) interviewed stated that they have not seen insects in the facility and see exterminators regularly fumigating the facility.

See LIC9099-C pages for more information. Page 1 of 2.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Jackie Jin
LICENSING EVALUATOR NAME: Christine Kabariti
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 26-AS-20250205155405
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131
FACILITY NAME: ROSE GARDEN COURT
FACILITY NUMBER: 435200967
VISIT DATE: 05/14/2025
NARRATIVE
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1 out of 6 residents (R1) stated to have killed a cockroach inside his/her bedroom but could not provide proof because no picture was taken. Based on observation of R1's bedroom, there were no observation of any cockroaches or other insects.

Based on document review, the licensee is taking measures to ensure the facility is free from pests as the licensee has an annual extermination service to prevent pest in the facility.

The Department has investigated the above allegation. Based on interview, record review and observation the above allegation is unsubstantiated. An unsubstantiated finding indicates that although the allegation listed above may have happened or was valid, there is not a preponderance of evidence to prove the allegation did or did not occur.

No deficiencies were cited per California Code of Regulations (CCR), Title 22.

An exit interview was conducted and was reviewed with Administrator Michael Rosete and a copy of this report was provided.


Page 2 of 2.
SUPERVISORS NAME: Jackie Jin
LICENSING EVALUATOR NAME: Christine Kabariti
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2