Roseville Care Center

In the surveyor’s words

From the most serious findings on record at Roseville Care Center, in the surveyor’s own words.

• No harm, potential for more than minimal, widespreadF812Jun 27, 2025

  Based on observation, interview and record review, the facility failed to ensure the proper dishwashing process and sanitary conditions were maintained in the dietetic services when: 1. Two serving metal pans with debris particles stacked together were found stored in a clean and ready-to-use storage area. 2. Dietary Aide (DA) 1 was not able to verbalize and/or demonstrate: -The practice of measuring the water temperatures for the automated dishwashing and -The knowledge of the temperatures and sanitation concentrations for the manual dishwashing by 3-compartment sink procedure. 3. The wash and rinse temperatures log and instructions of the dishwashing machine did not match the manufacturer's guidance. […]

• No harm, potential for more than minimal, widespreadF585Jun 25, 2021

  Based on observation, interviews and record review, the facility failed to maintain evidence of the results of any grievances for all residents in a census of 139 when: No record of grievances nor resolutions were retained by facility. This failure had the potential to violate the residents rights to file grievance and have it resolved. Findings: During an interview on 6/23/2021 at 11:25 a.m., the Social Service Assistant (SSA) stated that the Social Service Director (SSD) was the one who kept the Grievance log. SSA stated that SSA only kept the log for missing items. The missing items log was arranged alphabetically and filed one binder per year. During a concurrent interview and record review on 6/23/2021 at 1:50 p.m., the SSD stated that they never kept a grievance log. […]

• No harm, potential for more than minimal, widespreadF812Jun 25, 2021

  Based on observation, interview and facility policy review, the facility failed to ensure food was stored and prepared under sanitary conditions when: 1. Kitchen staff unable to explain the manual three-part sink dish washing steps; 2. Dusty fan by window with sill that had build-up of gray/black particles, leaving black smudge on finger when wiped; 3. Screen for kitchen window found with gap, allowing pest entry; 4. Dented cans found in canned good section for use.Food not properly cooled; 5. Floor under shelves in dry food storage with grayish, black build-up and was rough to touch; 6. Kitchen floor found with broken tiles; 7. Dishwasher not found with air gap; 8. […]

• No harm, potential for more than minimal, widespreadF814Jun 25, 2021

  Based on observation and interview, the facility failed to dispose of garbage and refuse properly in order to prevent the harborage of pests when the dumpster lid was left open. This failure increased the risk of an unsanitary environment due to the potential for flies and rodents on facility grounds. Findings: During an observation and interview on 6/22/21 at 4:04 PM, the dumpster lid was propped open with the stick, though no one was throwing away garbage. The DDS stated that the kitchen trash was left on a trolley outside of the kitchen for housekeeping, as housekeeping had responsibility over the dumpsters. […]

• No harm, potential for more than minimal, patternF759Jul 9, 2026

  Based on observation, interview, and record review, the facility failed to ensure the medication rate did not exceed 5% for three of three sampled residents, Resident 3, Resident 133 and Resident 13 when:1. Licensed Nurse 6 (LN 6) administered the medication Isosorbide Mononitrate 30 mg tablet (a prescription medication used to prevent chronic chest pain caused by coronary artery disease [heart condition where the major blood vessels supplying your heart become narrowed or blocked]) to Resident 3 without checking his blood pressure as prescribed by the physician;2. […]