Rosegate

On 05/07/2025 at 1:30pm Licensing Program Analysts (LPAs) L. Alexander and Y. Brown arrived unannounced to conduct a Case Management visit. LPAs met with Administrator, Jeffrey Tong. While LPAs L. Alexander and Y. Brown was conducting a complaint investigation (15-AS-20250430190433 ) on 05/07/2025. During tour of the facility, LPAs observed that Resident (R) R1's space to get to the bathroom was limited. LPAs brought this issue to S1 and S1 rearranged the room to accommodate better space so that R1 can move around to bathroom if needed. LPA's observed that there was oxygen in use in R2's room but there was no "Oxygen in Use" signage posted. LPA's observed at 11:54am in shared bedroom for R2 and R3 there was a bottle of Equate ClearLax laxative unlocked. LPA's observed during file review at 12:05pm that R1's admission agreement was signed 12 days after they were admitted and R1's file was incomplete and missing documents. The deficiencies were observed (see LIC809D) and cited from the California Code of Regulation, Title 22. Failure to correct the deficiencies may result in civil penalties. Exit interview conducted. A copy of this report and appeal rights provided

On 12/18/2025 at 10:00 AM, Licensing Program Analyst (LPA) Y. Brown arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Licensee Allen Leung and Back up Administrator Jeffrey Tong and explained the purpose of the visit. LPA toured facility with Backup Administrator Jeffrey Tong including but not limited to bedrooms, bathrooms, kitchen, common area and back yard. The facility consists two floors and twenty-two (22) rooms. There are no bodies of water observed. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. Hallway temperature was maintained at 73 degrees F. The hot water temperature of a random sample of residents rooms were measured at 113.5, 112.3, and 110.5 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of nonperishable and 2-day of perishable foods. Centrally stored medications, sharps and toxic are locked and inaccessible to residents in care. Smoke detectors and carbon monoxide detectors were in operating condition during visit. Fire extinguisher was last serviced on 3/19/2025. Emergency Disaster Plan was last reviewed on 2/18/2025. First aid kit was observed to be complete. Fire drill was last conducted on 10/8/2025. Continued on LIC809-C. 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 Continued from LIC809. LPA reviewed five (5) staff and six (6) resident records. LPA reviewed a sample of medication. Updated copies of the following documents were requested for facility file and are to be submitted to CCLD by 12/25/2025: LIC610D: Emergency disaster plan LIC500: (Personnel Record) LIC 308 Designation of Administrative Responsibility No deficiencies cited during visit. Exit interview conducted with Allen and Jeffrey and a copy of this report provided.

On 4/22/22 at 2:15 p.m. Licensing Program Analysts (LPA) G. Clark and L. Fici arrived unannounced to conduct Infection Control Inspection. Administrator, Jeffrey Tong arrived at 2:45 p.m. LPAs explained the purpose of the visit. During the Infection Control Inspection, LPAs toured facility including but not limited to: front entrance, screening station, hand washing stations, bedrooms, common areas, kitchen and backyard. Facility has a sufficient 2-day perishable and one week non-perishable food supply. Visitors policy is posted on the front entrance. There is one central entry point for universal screening for staff, residents and visitors. A sign-in policy, thermometer and hand sanitizer were observed at screening station. Cough/sneeze etiquette, social distancing and hand washing posters were observed. Facility staff were observed to be wearing proper PPE. Facility has a 30-day supply of PPE maintained at central location and easily accessible for staff. Facility has a mitigation plan and maintains record of routine screening for residents and staff. No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.

On 6/20/2022 starting at 10:45 AM, Licensing Program Analyst (LPA) L. Ibo conducted a health and safety check as a result of department receiving a priority 1 complaint. LPA met with Michael Fombang, assistant administrator and Jefferey Tong, back up administrator. Administrator is currently not available. During the health and safety check, LPA toured the building with Michael F. including but not limited to common areas, bathrooms, bedrooms and outdoor area. LPA observed smoke detectors and carbon monoxide detector throughout facility. LPA observed the following: S1 not fingerprint cleared and working at the facility. Deficiency is cited per Title 22 California Code of Regulations and listed on LIC9099D. Failure to submit proof of correction (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted. Appeal Rights and a copy of this report provided.

On 10/31/2025 at 9:30 AM, Licensing Program Analysts (LPAs) Y. Brown and L. Fontanilla arrived unannounced to conduct a Case Management visit. LPAs met with Administrator, Jeffrey Tong. While LPAs Y. Brown and L. Fontanilla were conducting a complaint investigation (15-AS-20251027194916) on 10/31/2025, LPAs observed 1. a staff member leaving a cart in the hallway that contained chemicals and disinfectants that were accessible to residents 2. the facility do not send incident reports to CCL The deficiencies were observed (see LIC809D) and cited from the California Code of Regulation, Title 22. Failure to correct the deficiencies may result in civil penalties. Exit interview conducted. A copy of this report and appeal rights provided

On 11/5/2025 at 9:00 AM, Licensing Program Analyst (LPA) Y. Brown arrived unannounced to conduct a POC (proof of correction) inspection. LPA met with House Manager, Irene DeLeon and informed her the reason for the visit. Facility has the following deficiency that was not cleared and deficiency was issued on 10/31/2025 from California Code of Regulations, Title 22 : - 87468.2(4); LPA has not received proof of an in-service training, replacement of the auditory device in the main entrance or installation of additional auditory devices in the side gate. Civil penalty of $200 is assessed for the period of 11/4/2025 to 11/5/2025 for failure to correct for each deficiency 87468.2(4). Total civil penalties in the amount of $200 is being assessed today. Facility is subject to ongoing civil penalties until deficiency is corrected. Exit interview conducted. A copy of this report, LIC421FC, and appeal rights provided.

On 03/06/2025 at 02:00 PM Licensing Program Analysts (LPAs) J. Clancy-Czuleger and Y. Brown arrived unannounced to conduct a Case Management. LPAs met with Jeffrey Tong, Administrator. LPAs came to discuss the number of showers present at the facility and what alterations will be needed to accommodate their current capacity of residents and what will be needed for a change of ownership. The facility was informed that they will need to obtain building permits from city/county and submit them to CCLD will a letter of explanation that includes a expected timeline of construction, how the facility will accommodate the residents during construction, along with an updated floor plan. Once construction has been completed the facility will contact CCLD to inspect the new bathroom. Exit interview conducted. A copy of this report and appeal rights provided.

On 11/25/2024 at 9:00 AM, Licensing Program Analysts (LPAs), Patricia Manalo and Jill Clancy-Czuleger, arrived to do a Case Management visit. LPA met with Assistant Administrator, Jeffrey Tong, and explained the reason for the visit. While LPAs was at the facility for another visit, LPAs observed the following deficiency: At 9:00 AM, LPAs was informed that there are nine (9) residents that are COVID-19 positive. At around 10:00 AM, while touring the facility, LPAs found that the facility did not report the outbreak to Local Public Health. At 10:30 AM, while touring the facility for a change of ownership inspection, LPAs observed that there are four bathrooms total in the facility. Two are on the second floor of which one is in a private room, and the other is only accessible to ambulatory residents. The other two are on the first floor and only one is accessible to non-ambulatory residents. The facility currently has 29 residents, 8 are ambulatory and 21 are non-ambulatory which means there is only one bathroom for 21 non-ambulatory residents. The deficiency was observed (see LIC 809D) and cited from the California Code of Regulation, Title 22. Failure to correct the deficiency may result in civil penalties. Exit interview conducted. A copy of this report and appeal rights provided.

On 1/23/25 at 10:15 AM, Licensing Program Analyst (LPA) Greg Clark arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Jeffrey Tong, Administrator and explained the purpose of the visit. LPA toured the facility including but not limited to 5 residents’ rooms, bathrooms, multiple activity rooms, kitchen, common area and courtyard. There are no bodies of water observed. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. Hallway temperature was maintained at 70 degrees F. The hot water temperature in a hall bathroom was measured at 105.5 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of nonperishable and 2-day of perishable foods. Centrally stored medications, sharps and toxic are locked and inaccessible to residents in care. Smoke detectors and carbon monoxide detectors were in operating condition during visit. Fire extinguisher was last serviced on 2/22/24. Emergency Disaster Plan was last posted on 2/16/24. First aid kit was observed to be complete. Fire drill was last conducted on 1/13/25 LPA reviewed 5 residents records and 5 staff records, and all were complete. LPA also reviewed a sample of resident’s medications. No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.

Licensing Program Analyst (LPA) K. Nguyen arrived unannounced to conduct a case management visit on this date to verify if an individual is currently employed at the facility. Based on evidence obtained during today’s visit, the LPA has verified the individual is not present, employed, or residing at the facility. LPA has advised the administrator to disassociate the individual from their roster and submit an updated LIC 500. Exit interview conducted and a copy of this report provided via email.

Based on information obtained, R1, R2 & R3’s death certificate indicated that three residents died of natural cause. The Department received records indicating R1 & R3 was receiving hospice care under Suncrest Hospice and R2 was receiving hospice under Pathways Hospice. Based on records review R1, R2 & R3 received medications as prescribed by doctors, no suspected neglected or abuse observed. Based on records review, on 12/1/2021 R1 was admitted on hospice and passed away on 6/10/2022 with caused of death of vascular dementia. Based on records review, on 1/3/2022 R2 was transferred to Suncrest hospice. Records review revealed that on 6/1/2022, 6/2/2022 ,6/3/2022 and 6/4/2022, there was no indication of administering morphine. On 6/10/2022, R2 passed away with caused of death of Alzheimer’s. Based on records review, on 5/23/2022 R3 was admitted under Suncrest Hospice. On 6/8/2022, R3 passed away with caused of death of Senile dementia of the nervous system. This agency has investigated the complaint. Although the allegations may have happened or are valid, there are not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED. Exit interview conducted with Jeffrey Tong and a copy of this report provided.

On 10/31/2024 at 8:45AM, Licensing Program Analyst (LPA) J Clancy-Czuleger and P Manalo while at the facility for a pre-licensing observed the following deficiencies: water temperature is 123.6 degrees Chemicals were observed unlocked in storage/shower room there is not a compliance poster posted rooms that have oxygen stored do not have signs posted residents do not have updated needs and services plans residents with dementia do not have updated physicians reports Deficiency is cited from Title 22 California Code of Regulation (see 809D). Failure to submit proof of correction and any repeat violation within twelve-month period may result in additional civil penalties. Exit interview conducted. Appeal Rights, and copy of this report provided via e-mail.

On 1/25/2023 at 2:45 PM, Licensing Program Analyst (LPA) P. Watson arrived unannounced to conduct an annual Infection Control Inspection. LPA met with Administrator, Jeffrey Tong and explained the purpose of the visit. During the Infection Control Inspection, LPA toured facility with Jeffrey including but not limited to front entrance, hand washing stations, bedrooms, dinning room, kitchen, and backyard. Facility has a sufficient 2 day perishable and one week non-perishable food supply. Visitors policy is posted on the front entrance. There is one central entry point for universal screening for staff, residents, and visitors. A sign-in policy, Covid questionnaires, thermometer and hand sanitizer were observed at screening station. Hand washing posters were observed. Common touched surfaces are disinfected at least once daily. Bathrooms are equipped with liquid soap, paper towel and trash bins. Facility staff were observed to be wearing proper PPE. Facility has a 30 day supply of PPEs maintained at central location and easily accessible for staff. Facility has a mitigation plan and maintains record of routine screening for residents and staff. Smoke and carbon monoxide detectors were observed and are connected to the sprinkler system. First Aid kit was complete. Fire extinguisher was observed serviced. LPA observed facility passages free of obstruction. No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.