Blessed Blissful Home Care 2

Type of visit: Office

On 12/06/22 at 11:00 am a non-compliance conference meeting was held for this facility. Licensee Loureana Somodio and Elaine Somodio of Blessed Blissful Home 2, Regional Manager (RM) Benita Yates, Licensing Program Managers (LPMs) Janae Hammond, and Eva Alvarez, and Licensing Program Analysts (LPAs) Ernand Dabuet and Jose Calderon were all present at this meeting. LPA Dabuet explained additional deficiencies associated with the annual required inspection on 11/27/22 will be cited. LPA Dabuet reviewed personnel records on 11/27/22 and found files to be incomplete: Lorie Somodio - Administrator (Employee Rights LIC 9052) Eman Somodio - Caregiver (Incomplete file) Charmaine Alcantara - Assistant Administrator (incomplete file) Juliana Vasquez - Caregiver (SOC 341 & Employee Right LIC 9052) Flordeliza Robles - Caregiver (Incomplete file) The licensee and administrator failed to submit a death report LIC 624A to Community Care Licensing (CCL) for a resident who passed away at the facility in April 2022. The administrator is being cited according to Administrator's Qualifications Regulations 87405 resulting in multiple deficiencies cited. Based on interviews and observation, and record reviews the licensee violated the California Code Regulations (CCR) of Title 22, Division 6, Chapter 8 Deficiencies are issued and an exit interview is conducted with Lorie Somodio A copy of this report is provided along with the appeal rights.the state’s words, verbatim · CDSS document, Dec 6, 2022

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87405(b)(2) · Plan of correction due date: Dec 20, 2022

87405(b)(2) Administrator-Qualificaitons and Duties. (b) The administrator of a facility or facilities shall have the responsiblity and authority to carry out the policies of the licensee. (2) Knowledge of and ability to conform to the applicable laws, rules and regulations. This requirement was not met as evidence by: Based on interview and record reviews the administrator failed to adhere to Title 22 regulations, resulting to multiple citations, This violation poses a potential health and safety to residents in care.the state’s words, verbatim · CDSS document, Dec 6, 2022

Plan of correction: The licensee will create a plan to ensure that the administrator performs knowledge of and donforms to applicable laws, rules and regualitons. A written statement from licensee that reviewed 87405 proof of correction sent by fax 323-981.1781 to El Segundo Regional office by 12/2022.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87211(a)(1)(A) · Plan of correction due date: Dec 20, 2022

87211(a)(1)(A) Reporting Requirements licensee shall furnish to the licensing agency such reports as the Department... (1) A written report shall be submitted to the licensing agency... within seven days..(A) Death of any resident from any cause regardless of where the death occurred... This requirement was not met as evidence by: Based on interview and record review, administrator failed to submit a death report was not sent to CCLD for resident who passed in April 2022. This violation poses a potential health and safety to residents in care.the state’s words, verbatim · CDSS document, Dec 6, 2022

Plan of correction: Licensee will adhere to the regulations and will ensure any changes in resident's health condition or death will be reported to CCLD. Licensee will ensure to provide proof of correction sent by fax 323-981.1781 to El Segundo Regional office by 12/2022.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87412(a)(1-13) · Plan of correction due date: Dec 27, 2022

87412 Personnel Records a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information:.... This requirement was not met as evidence by: Based on record review, all staff had incomplete records and missing required forms. This violation poses a potential health and safety to residents in care.the state’s words, verbatim · CDSS document, Dec 6, 2022

Plan of correction: Liensee will review 87412 Personnel Record and send complete file for each employee. Proof of correction sent by fax 323-981.1781 to El Segundo Regional office by 12/27/22.

Type of visit: Required - 1 Year

On 11/27/22, Licensing Program Analyst (LPA) Ernand Dabuet conducted an unannounced annual required visit with a primary focus on Infection Control measures using the CARE Inspection Tool. LPA met with administrator Lorie Somodio and explained the purpose of today’s visit. The facility is licensed to operate for six (6) elderly adults of which two (2) may be ambulatory and three (3) non-ambulatory. One (1) may be bedridden. The facility is approved for four (6) hospice residents. Currently, there are four (4) hospice resident in care. The facility is a single-story structure located in a residential neighborhood. It consists of the following: (5) resident's rooms, two (2) common bathrooms, a living area, a dining area, a kitchen, and an outside covered patio area. LPA and licensee toured the physical plant. There were no bodies of water on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for resident personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. Bathrooms were found to be within Title 22 regulations and were clean and operational. A comfortable temperature of 72 degrees was maintained in the facility. LPA observed the facility to be appropriately furnished at the time of visit. Storage areas for personal hygiene, and sharps objects were stored and not accessible to residents. The kitchen was inspected and there is sufficient perishable and non-perishable food available maintained properly. The facility has two (2) fire extinguishers that were charged, smoke detectors, and carbon monoxide was operable. LPA reviewed Medication Administration Records (MAR). The facility conducted a Fire/Safety Drill on 10/05/22. A working landline telephone remains available. Evaluation Report Continues on LIC 809-C INFECTION CONTROL: During the visit, LPA observed the facility's infection control practices. LPA observed screening protocols for visitors, staff, and residents, and sanitizing stations in common areas and restrooms. LPA observed staff wearing face coverings, LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. A review of the resident's and staff's vaccination records was conducted. The facility has a Mitigation Plan Report on file with CCLD. DEFICIENCIES: Based on interviews, observation, and record reviews, LPA identified staff #2, staff #3, and staff #5 with no evidence of Criminal Record Background Clearance for the staff to be associated with the facility. LPA identified cleaning materials and disinfectants that were left under bathroom sinks in unlocked cabinets. LPA observed prescription medications contained in a small plastic cup left on the dining room cabinet exposed/unattended to the resident in care. LPA observed with the licensee a water hose and laundry basket obstructing the emergency passageway. LPA tested hot water temperature at 98.5 F and 100.0 F not compliant with Title 22 regulations. Due to time constraints, an annual continuation will be required at a later visit. Based on interviews, observation, and record reviews the licensee violated the California Code Regulations (CCR) of Title 22, Division 6, Chapter 8, Deficiencies are issued and an exit interview is conducted with Lori Somodio. A copy of this report, appeal rights, and civil penalty were provided.the state’s words, verbatim · CDSS document, Nov 27, 2022

Type of visit: Post Licensing

On 11/10/21 at 10:14 am, Licensing Program Analyst/ (LPA) Susan Campos, conducted a post licensing inspection visit at the Blessed Blissful Home Care 2 facility. LPA was allowed entry into the facility by Laureana Somodio, Administrator. The facility is licensed for six (6) non-ambulatory residents age 60 and over, and includes hospice waiver for 6. Currently, there are 2 residents, one ambulatory and one non-ambulatory, residing in the facility. LPA explained to Ms. Somodio the purpose of the visit, and escorted LPA on a tour of the entire inside and outside facility grounds. As part of the inspection, LPA Campos reviewed: (2) resident service records, (2) resident medication records, and (2) staff member record, and inspected the inside facility and outside grounds. The facilities’ last fire drill was conducted on 11/2/21. The one story house located in a residential neighborhood consists of (4) resident bedrooms, (1) office, (2) resident bathrooms, living room, dining room, kitchen, attached garage/ storage/ laundry area, covered front porch area with seating for (2) people, and table with four chairs, and a back yard patio cover with two seat chairs and a table, and also an umbrella, table and six chairs. No weapons are stored in the premises. Kitchen was inspected and observed to be clean and operational. A 2- day supply perishable and 7-day supply of non-perishable foods are present in the facility. Emergency Water/ food Storage is located in the garage. Staff are following modified diets as prescribed by doctors orders per menu posted in the facility. LPA observed that all facility rooms are clean and in good repair. A comfortable temperature was observed, and the facility has central air and heating. LPA observed the following during inspection of residents rooms: mattresses are in good condition, adequate lighting present, plenty of dresser/closet space is present, and all bed linens present. All bedrooms contain furniture, lighting fixtures and personal storage space as required, all beds have the required amount of linen and mattress covers, LPA observed fully stocked closet with Continued on LIC 809C bedding, towels, and toiletries supplies. Bathroom fixtures are clean, in good repair, and working properly and contain the required nonskid mats and grab bars. LPA observed bathrooms were found to be within Title 22 regulation. Bathroom #1 hot water temperature properly measured by LPA at 11:45 am to be 107.1 degrees Fahrenheit. Facility (5) Carbon Monoxide/ Smoke Detectors hardwired and connected were tested and working properly. The facility (2) Fire Extinguishers were checked and found to be fully charged and accessible. All exit doors in the facility have alarm systems. All toxins and knifes are locked/secured and inaccessible to residents. Medications are centrally stored and in a locked storage cabinet. Facility first aid kit is fully stocked with manual was checked and is in order. Outside grounds were toured and no bodies of water were observed. All Exits/ Walkways around the home were free of debris and hazards. Outside patio accessible to residents. Two (2) resident files were reviewed and found to be complete. LPA reviewed (2) resident medications and they were all found to be administered according to doctor's orders. Two (2) staff files were checked and have the required documents. The facility does not handle resident's money/cash resources. All the required documents are posted in the facility in a clearly visible area. The facility has an Administrator with valid Certificate #6032285740, Expiration Date: 10/30/22. According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA did not observe deficiencies therefore no citations were issued at this time. An exit interview was conducted and a copy of the Facility Evaluation Report was provided to Laureana Somodio.the state’s words, verbatim · CDSS document, Nov 10, 2021