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ICF/DD-N (Nursing)License activeMedi-Cal certified

ROSE DIVISION

ICF/DD-N (Nursing) · 6 licensed beds · Bellflower, CA

Homes of 4–15 beds for medically fragile people with developmental disabilities who need intermittent skilled nursing.

Address

ROSE DIVISION9632 ROSE STBellflower, CA 90706 · Los Angeles County

Phone: (562) 866-7054

Facility details

CDPH listing, data as of Oct 16, 2026
Facility type
ICF/DD-N (Nursing)
Licensed beds
6
Licensee
HARBOR HEALTH CARE, INC. · Profit Corp
CDPH facility ID
960000872
License number
960000480
First licensed
September 18, 1989
Current license
Jan 4, 2026 to Jan 3, 2027
CDPH district office
La Icf/Dd/Clinics

Federal certification (CMS)

CMS Provider of Services file
CMS Certification Number (CCN)
05G383
Status in CDPH's listing
Licensed And Certified
Program
Medi-Cal (Medicaid, Title XIX)
Participating since
September 19, 1989
Last certification survey
January 22, 2026
CMS certification status
Certified
In compliance (CMS)
Yes
Last certification action
Recertification
Ownership type (CMS)
Private (proprietary)
Certified beds (CMS)
6
Staffing reported to CMS
RN 0.25 · LVN/LPN 1 · direct care 4.25 · all employees 5.5

State citations and penalties (CDPH)

7 penalties, newest first

CDPH issues citations under Health and Safety Code §1424: Class AA (a violation that was a substantial factor in a resident's death), Class A (imminent danger or a substantial probability of death or serious harm) and Class B (a direct relationship to residents' health, safety or security). State citations explained

  • Class BStaffing

    Citation - B · Violations: 483.420(d)(1)(i), T22 DIV5 CH8.5 ART3-76870 · Violation Jun 18, 2024 · Penalty #960020540 · Survey R7Y911

    Status: Closed

  • Class BAbuse/Facility Not Self Reported

    Citation - B · Violations: W&I 4502(b)(8), 1418.91(a), W&I 4502(a) · Violation Feb 9, 2023 · Penalty #960019896 · Survey K7FA11

    Status: Closed · Not appealed

  • Class APatient Care

    Citation - A · Violations: 483.420(a)(5), 483.420(d)(4) · Violation Feb 2, 2021 · Penalty #960016409 · Survey 871Q11

    Status: Closed · Not appealed

  • Class BPatient Rights

    Citation B (HSC 1424) · Violation Jun 4, 2012 · Penalty #960009932 · Survey 8FG111

    Status: Closed · Not appealed

    $1,000

  • Class BPatient Rights

    Citation B (HSC 1424) · Violation Apr 5, 2011 · Penalty #960008417 · Survey 8E0D11

    Status: Closed · Not appealed

    $500

  • Class BPatient Care

    Citation B (HSC 1424) · Violation Sep 28, 2000 · Penalty #960000875

    Status: Closed · Not appealed

    $2,700

    initially $900

  • Class BPatient Care

    Citation B (HSC 1424) · Violation Nov 30, 1999 · Penalty #960000822

    Status: Closed · Appealed (received Jan 6, 2000)

    $900

Federal inspections (CMS-2567)

39 surveys since 2018 · CMS data through Oct 12, 2026

CDPH surveys certified ICFs for CMS. Each deficiency is a W-tag (a federal ICF/IID requirement), an E-tag (emergency preparedness) or a K-tag (Life Safety Code), cited at the standard level or, more seriously, the condition level. How to read an ICF inspection

Content note: these federal findings describe residents' care and can include abuse, neglect, injuries and medical details. They're shown as CMS published them; residents are identified only by number (such as "Client 1").

  1. · Complaint

    Event 2F5A10-H1 · no deficiencies cited

    Official 2567 ↗
  2. · Recertification

    Event SU0111 · 5 deficiencies

    Official 2567 ↗
  3. · Recertification

    Event SU0121 · 5 deficiencies

    Official 2567 ↗
  4. · Complaint

    Event VBE111 · no deficiencies cited

    Official 2567 ↗
  5. · Complaint

    Event WZOY11 · 1 deficiency

    Official 2567 ↗
  6. · Complaint

    Event D2LZ11 · no deficiencies cited

    Official 2567 ↗
  7. · Complaint

    Event 6KMS11 · no deficiencies cited

    Official 2567 ↗
  8. · Recertification

    Event XJU121 · 2 deficiencies

    Official 2567 ↗
  9. · Recertification

    Event XJU111 · 2 deficiencies

    Official 2567 ↗
  10. · Complaint

    Event R7Y911 · 2 deficiencies

    Official 2567 ↗
  11. · Complaint

    Event 705511 · no deficiencies cited

    Official 2567 ↗
  12. · Complaint

    Event OZK911 · no deficiencies cited

    Official 2567 ↗

From CMS's QCOR ICF/IID statement-of-deficiency download, saved Oct 26, 2026. CMS notes that ICF/IID data after March 19, 2026 may be incomplete while its systems migrate. Plans of correction and state-only (licensing) deficiencies aren't in that file; the official 2567 documents on CalHealthFind have them.

Complaints and reported incidents

CDPH doesn't publish complaints or facility-reported incidents as a bulk file, so they aren't on ICFLookup. Its CalHealthFind page for this facility lists them (intake date, allegation category and whether each was substantiated), along with state licensing deficiencies and ownership details.

Federal surveys that came from a complaint or an incident report do appear above, marked "Complaint" as the survey type.

Open this facility on CalHealthFind ↗How to file a complaint with CDPH

Change history

47 events, newest first

Dates marked "state record" are the agencies' own: the license date, federal survey dates and penalty issue dates. "Detected" changes are ones we noticed by comparing CDPH's monthly facility listing with the one before it, tracked since Oct 26, 2026.

  1. ReportFederal survey (complaint): no deficiencies(state record)

    See this survey →
  2. ReportFederal survey (recertification): 5 deficiencies(state record)

    See this survey →
  3. ReportFederal survey (recertification): 5 deficiencies(state record)

    See this survey →
  4. ReportFederal survey (complaint): no deficiencies(state record)

    See this survey →
  5. ReportFederal survey (complaint): 1 deficiency(state record)

    See this survey →
  6. ReportFederal survey (complaint): no deficiencies(state record)

    See this survey →
  7. ReportFederal survey (complaint): no deficiencies(state record)

    See this survey →
  8. ReportFederal survey (recertification): 2 deficiencies(state record)

    See this survey →
  9. ReportFederal survey (recertification): 2 deficiencies(state record)

    See this survey →
  10. ReportState Class B citation ($3,000)(state record)

    See this citation →

Sources: CDPH Licensed and Certified Healthcare Facility Listing (data as of Oct 16, 2026), CDPH State Enforcement Actions, and CMS's ICF/IID statement-of-deficiency (CMS-2567) and Provider of Services files. ICFLookup is not affiliated with CDPH or CMS; always confirm with CDPH's CalHealthFind ↗ before making a decision. See How our data works.