Facility Evaluation Report

Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced visit to Rosehaven I. The purpose of today’s visit was to conduct the Annual Required inspection. LPA was allowed entry into the facility and explained the reason for the visit. Facility is licensed for 6 non-ambulatory residents, of which one may be bedridden. Facility has an approved hospice waiver for 5 residents and the home currently has 4 residents with 2 on hospice during today's visit. Administrator Jaya Pichika has submitted the administrator certificate renewal as of March 5, 2026.

LPA Lyman along with Caregiver Larry Espansol toured the facility at 8:34 AM. Administrator Jaya Pichika arrived during the visit. LPA toured the physical plant, checked food service, reviewed records and the first aid kit. Facility appears to be clean, safe, and sanitary. The home consists of six resident bedrooms, one resident restroom, two common restrooms, one staff room, living room, dining room, and kitchen. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. LPA observed one resident with half bed rails and one with full bed rails. Resident restrooms were checked. Toilets and water faucets worked properly, grab bars were secure and shower was free of mold/mildew. Water temperature measured between 122 and 125.2 degrees F in all facility restrooms. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked at time of visit. Common areas were clean and clear of hazards, doorways were free of obstructions. First aid kit had all the required elements including tweezers, thermometer, and scissors. The entry door into the garage is secured. LPA observed a locked storage area for cleaning supplies. Kitchen was inspected. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. LPA observed sharps locked in a kitchen drawer. Fire extinguishers are fully charged. Kitchen appliances are operational during today's visit. CONT ON LIC809-C DATED 04/23/2026