Blue Morpho Assisted Living

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Katie Brown conducted this Case Management in conjunction with a complaint investigation (Complaint Control Number 24-AS-20260721102800). LPA explained the reason for this visit with Administrator (AD) Kameron Green. During this visit, LPA toured the facility and conducted resident file review. During the tour, LPA observed that Resident (R1's) hospital bed has full side rails attached. It was confirmed that R1 is not on Hospice at the time of today's visit. AD has agreed to provide R1's Physician's Report via email. A deficiency is being cited in accordance with California Code of Regulations on the attached LIC 9099-D. An exit interview was conducted and Plan of Correction was developed. A copy of this report and Appeal Rights were discussed and provided.the state’s words, verbatim · CDSS document, Jul 29, 2026

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87608(a)(5)(B) · Plan of correction due date: Aug 7, 2026

87608 Postural Supports (a)Based on the individual's preadmission appraisal… Postural supports may be used... (5) Under no circumstances… or limiting the use of a resident's hands or feet. (B) Bed rails that extend the entire length of the bed are prohibited except for residents who are currently receiving hospice...This requirement was not met as evidenced by: On 7/29/26, it was observed that R1 was laying in a hospital bed with full bed rails fastened to both sides. This poses a potential health & safety risk to residents in care.the state’s words, verbatim · CDSS document, Jul 29, 2026

Plan of correction: During the visit, AD cummunicated with R1's Physician and 1/2 rails were ordered. R1's care plan will be updated with new safety and fall interventions. Updated care plan will be submitted to CCL by poc date.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sarah Hurt conducted an unannounced visit today for the facility’s annual inspection. LPA met with Administrator Kameron Green, Continual Administrator's Certification expires 11/05/2027. There are currently 6 residents who reside at this home and there is 1 residents on hospice at this time. LPA inspected the interior and the exterior of the facility including the common living spaces, resident bedrooms and bathrooms, activity rooms, medication storage, kitchen, garage and outdoor areas. Bedrooms were clean and in good repair. There is a locked storage for medications. Food supply is adequate for 2-day perishable and 7-day nonperishable. Smoke alarms were tested and are operational. The home has a carbon monoxide detector and performs disaster drills as required. Water temperature was tested at 118 degrees. First Aid kit is on site and complete. Toxins and cleaning supplies are locked and inaccessible. LPA reviewed facility facility Emergency Disaster Plan, Infection Control Plan, Staff Files, Resident Files, Plan of Operation. Staff 1 is not fingerprint cleared. Staff 1 does not have a Personnel record available to review. The facility did not report Resident 1's hospitalization to State Licensing. Staff 2 and 3 are not fingerprint associated to this facility. The following deficiencies observed or cited during today's inspection per California Code of Regulations, Title 22. LPA requested the following documents: LIC 500 Personnel Report, LIC 308 Designation of Administrative Responsibility, LIC 610-E the Emergency Disaster Plan and copy of current Administrator’s Certificate to update the facility file. Listed documents shall be sent to Licensing. Exit interview conducted with Administrator, Kameron Green, and copy of report left at facilitythe state’s words, verbatim · CDSS document, Mar 7, 2026

The state marks this report as 5 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Rachel Bruce arrived at the facility to conduct the Pre-Licensing Inspection. LPA met with Administrator (AD) Kameron Green. LPA began the tour by entering through the front door of the 5 bedroom/3 bathroom/1 story home. Interior common areas have adequate furnishings and lighting. Along with adequate lighting and a chair, all 5 client bedrooms have the required beds, night stands with drawers and closet space or chest of drawers. LPA verified there were adequate bed linens stored in hall closet. Smoke and Carbon Monoxide detector combination alarms are located throughout and were observed to be in working order. LPA observed an adequate supply of towels. There will be a more adequate supply of personal hygiene and grooming products once there are residents and their needs are known. AD will ensure along with towels there will be a supply of paper towels available in the bathrooms. Hot water temperature in bathrooms met regulatory requirements. Non-Skid mats and grab bars were present in the showers. Kitchen observed to have supply of dishes, plates, pots and pans, and utensils for 6. Food storage and preparation areas are clear and appropriate for food preparation. Cleaning supplies and chemicals are locked in the garage cabinet. Sharps/knives are located in a locked pantry/closet in the kitchen area. Appliances observed to be in working order. LPA did not observe a 7 day supply of non-perishable food, but AD understands the requirements once residents are in place. First aid kit contains all the required items. There were two fire extinguisher present with proof of purchase attached. Washer and Dryer observed in the laundry room with additional storage space available in upper cabinets. Locked laundry detergent can be found with the chemicals in the garage. Doors and passageways are unobstructed throughout the home. Outside of the facility toured. There is a covered seating area and a self-latching gate found to be working properly. The home does not have a pool. An exit interview was conducted as well as a COMP III power point presentation. A copy of this report will be emailed to AD. AD will notify CCL when the first resident is in place which will trigger a post licensing inspection.the state’s words, verbatim · CDSS document, Mar 13, 2025

Type of visit: Office

Facility Type: RCFE Application Type: Initial Capacity: 6 Census (if any clients in care): none COMP II Participants: Kameron Green Interview Method: Telephone interview On February 14, 2025, applicant/administrator participated in COMP II. Identification of the applicant and administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant and administrator confirmed that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2.Activities, medication storage, transportation 3. Staffing requirements & Training 4. General provisions 5. Pre-licensing readinessthe state’s words, verbatim · CDSS document, Feb 14, 2025