<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 565850358
Report Date: 06/16/2026
Date Signed: 06/17/2026 09:10:29 AM

Document Has Been Signed on 06/17/2026 09:10 AM - 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, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME:ROSE GARDEN MANORFACILITY NUMBER:
565850358
ADMINISTRATOR/
DIRECTOR:		SORATORIO, AMALIAFACILITY TYPE:
735
ADDRESS:1731 S. VENTURA ROADTELEPHONE:
(805) 890-0607
CITY:OXNARDSTATE: CAZIP CODE:
93033
CAPACITY: 6CENSUS: 6DATE:
06/16/2026
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:10 AM
MET WITH:Amalia Soratorio, AdministratorTIME VISIT/
INSPECTION COMPLETED:
05:40 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
Licensing Program Analyst (LPA) Kristin Kontilis conducted an unannounced required Annual Inspection to the above-named facility. Upon first arrival, there was no answer at the door. LPA contacted Administrator Amalia Soratorio who stated there were no clients or staff at the residence and Administrator was out of the facility on personal business. Upon second arrival at approximately 12:04 pm, LPA was greeted by Assistant Administrator Cindy Soratorio and Administrator Amalia Soratorio. LPA explained the purpose of the visit.

The facility is an adult residential care facility for ambulatory clients with intellectual disabilities. All clients are recipients of services through Tri-Counties Regional Center (TCRC). There are currently six clients residing in the facility. At the time of the visit, all clients were attending an adult day program.

Entrance interview conducted:
A tour of the physical environment and accommodations were assessed, and the following was noted: LPA observed the required posting of the complaint poster and Resident’s Rights. LPA inspected the one-story facility for fire safety, personal accommodations, and food service. First aid kits and additional first aid supplies were observed to be complete.
LPA toured the facility with Administrator. Bedrooms #1, and #5 are private bedrooms. Bedrooms #2 and #3 are private bedrooms with a shared bathroom. Bedroom #4 is a shared bedroom. There is one bathroom off the hallway and is accessible to all clients in care.
Carbon monoxide detector and smoke alarms were tested and are in good working order. LPA observed three fire extinguishers last serviced on 9/12/2025.

Please continue to 809-C, Pg 2.

NAME OF LICENSING PROGRAM MANAGER: Kelly Burley
NAME OF LICENSING PROGRAM ANALYST: Kristin Kontilis
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/16/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/16/2026
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 7
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 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: ROSE GARDEN MANOR
FACILITY NUMBER: 565850358
VISIT DATE: 06/16/2026
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
26
27
28
29
30
31
32
 There is a sufficient amount of non-perishables for seven (7) days and perishables for two (2) days. LPA observed spoiled foods: one head of lettuce; ½ head of cabbage, and parts of 3 cucumbers.
Emergency food is stored in the garage. Cleaning solvents are kept in the garage along with the washing machine and a clothes dryer.
The backyard consists of a paved patio and various fruit trees. The recycling bin, green waste bin, and trash bins are standard bins with flip lids. LPA observed faux brick covering on the outside wall of the facility separated from the wall with stucco missing from the wall.
Residents records were reviewed. Admission Agreements, Health Screenings, Needs and Services Plans, Appraisals, Pre-Appraisals, Consent Forms, Physician's Reports have been signed and all records are current.
All persons associated with the facility have criminal record clearance. Administrators’ certificates are valid. Staff files reviewed had criminal record statements, health screenings, current first aid certificates, and all required training.

Pursuant to Title 22, California Code of Regulations, the following deficiencies are cited (refer to LIC 809-D). Technical violations noted.

Exit interview conducted.

Due to technical difficulties, copy of report and appeal rights issued via email.

NAME OF LICENSING PROGRAM MANAGER: Kelly Burley
NAME OF LICENSING PROGRAM ANALYST: Kristin Kontilis
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/16/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2026
LIC809 (FAS) - (06/04)
Page: 3 of 7
Document Has Been Signed on 06/17/2026 09:10 AM - It Cannot Be Edited


Created By: Kristin Kontilis On 06/16/2026 at 05:18 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: ROSE GARDEN MANOR
FACILITY NUMBER: 565850358

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/16/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
80076(a)(7)
Food Service
(a) In facilities providing meals to clients, the following shall apply: (7) Commercial foods shall be approved by appropriate federal, state and local authorities. All foods shall be selected, transported, stored, prepared and served so as to be free from contamination and spoilage and shall be fit for human consumption. Food in damaged containers shall not be accepted, used or retained.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation and interviews conducted], the licensee did not comply with the section cited above when food items (iceberg lettuce, cabbage, and parts of cucmbers) were observed to be spoiled and not fit for human consumption which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/16/2026
Plan of Correction
1
2
3
4
Administrator agreed to discard spoiled food items. POC cleared at time of inspection.
Type B
Section Cited
CCR
80087(a)(
80087(a) Buildings and Grounds: The facility shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation and interview, the licensee did not comply with the section cited above when a faux brick covering along the backwall was observed to be separated from the stucco wall in approximately 4 places which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/22/2026
Plan of Correction
1
2
3
4
Administrator agrees to have the covering removed and stucco re-surfaced no later than POC due date (6/22/2026). Administrator agrees to send photos of removed covering and stucco re-surfaced directly to LPA via email.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Kelly Burley
NAME OF LICENSING PROGRAM MANAGER:
Kristin Kontilis
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 06/16/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/16/2026


LIC809 (FAS) - (06/04)
Page: 4 of 7
Document Has Been Signed on 06/17/2026 09:10 AM - It Cannot Be Edited


Created By: Kristin Kontilis On 06/16/2026 at 07:29 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: ROSE GARDEN MANOR
FACILITY NUMBER: 565850358

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/16/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
80075(b)(5)(B)
80075(b)(5)(B) Clients shall be assisted as needed with self-administration of prescription and nonprescription medications. (5) If the client's physician has stated in writing that the client is unable to determine his/her own need for nonprescription PRN medication, but can communicate his/her symptoms clearly, facility staff designated by the licensee shall be permitted to assist the client with self-administration, provided all of the following requirements are met: (B) Once ordered by the physician the medication is given according to the physician's directions.

This requirement is not met as evidenced by:


This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on interviews conducted and records reviewed, the licensee did not comply with the section cited above when one client’s medication had an unexplainable shortage of 11 tablets (Start date 6/1/2026, quantity of 28, 1 tablet taken 1x/day in the AM, 0 tablets remaining in medication packet) which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 06/18/2026
Plan of Correction
1
2
3
4
Administrator agrees to submit a written plan in place to ensure start dates for medications are accurately noted and medications are self-administered per Physician’s order. Administrator agrees to submit POC directly to LPA via email no later than due date (6/18/2026).
Section Cited
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
4
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Kelly Burley
NAME OF LICENSING PROGRAM MANAGER:
Kristin Kontilis
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 06/16/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/16/2026


LIC809 (FAS) - (06/04)
Page: 7 of 7