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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 517003766
Report Date: 12/12/2024
Date Signed: 12/12/2024 03:12:45 PM

Document Has Been Signed on 12/12/2024 03:12 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
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:ROSEWOOD CARE CENTERFACILITY NUMBER:
517003766
ADMINISTRATOR/
DIRECTOR:		REBECCA BUTLERFACILITY TYPE:
735
ADDRESS:1547 PLUMAS COURTTELEPHONE:
(530) 751-9950
CITY:YUBA CITYSTATE: CAZIP CODE:
95991
CAPACITY: 40CENSUS: 40DATE:
12/12/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:05 PM
MET WITH:Angie KarisTIME VISIT/
INSPECTION COMPLETED:
03:20 PM
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LPA Hiratsuka conducted this unannounced annual visit. LPA toured with Angie Karis. Administrator Rebecca Butler was not present during today's visit.

LPA toured the facility with Administrator. The main entrance to the building opens to a reception area. The reception area is shared by this program and Willow Glen Care Center 515001963. From the reception area this program is on the left and the other program is on the right. Both are licensed by Community Care Licensing Division. The do not share any other doors and common areas. This facility has one wing and there is a staff and medication area that observes the residents. There is a dining area and a common area at the end of the wing, and one at the entrance.

LPA conducted the annual at the same time as Willow Glen Care Center 515001963, with the permission from Administrator Angie Karis who covers for Administrator Rebecca Butler when Ms. Butler is not present and vice/versa.

Multiple topics discussed.


No deficiencies cited.
SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Kerry Hiratsuka
LICENSING EVALUATOR SIGNATURE: DATE: 12/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/12/2024
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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