Bliss Care Home

Type of visit: Required - 1 Year

This unannounced inspection is being conducted by Licensing Program Analyst (LPA) Sean Haddad for the purpose of conducting a Required – 1 Year Inspection. LPA met with Administrator (AD) Nidhi Nandwani and discussed the purpose of the inspection. LPA reviewed Infection Control requirements. At about 11:00AM, LPA and AD conducted a tour of the inside and outside of the facility, common areas, resident rooms, kitchen, and garage and observed the following: Structure: facility is a 6-bedroom, 3-bathroom, one-story house with a detached garage that is used for storage. There is a back yard with a patio cover for the residents. LPA and AD observed 3 staff and 6 residents present at the facility. Resident Bedrooms: the 5 resident bedrooms are spacious and will easily accommodate the residents’ furnishings. Furniture for each resident bedroom inspected. Staff Bedrooms: LPA inspected the one staff bedroom. Bathrooms: the bathrooms were clean, faucets and toilets were operational. Water temperature: tested between 109 and 110 degrees F in the 2 resident bathrooms. Linens & Hygiene Supplies: new linens and fully stocked linen closets were observed. Emergency Phone Numbers, Exit Plan & Menu: reviewed. Food Service: LPA observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food is available as required by regulations. Carbon Monoxide, Smoke Detectors, Fire Extinguisher: observed and tested. Appliances: stove burners, microwave, washer, and dryer inspected. Knives: observed locked in the kitchen. Toxins: observed locked in the garage. Medication cabinet: observed to be locked. First-Aid Kit and Activity Supplies: observed and available. Facility’s licensing fees are paid. At about 7:50AM, LPA reviewed 6 resident files and 4 staff files, interviewed 2 residents and 2 staff, and inspected medications for 6 residents. Facility does not handle resident money. LPA provided California Department of Public Health informational material on Legionnaires’ Disease during the inspection. During the inspection, LPA and AD observed the following: based on documents, S2 and S4 have TB test results but do not have health screenings confirming their ability to perform their duties; and based on documents, R4's physician's report is from January 2025 and is on the old form and does not have required information, including behavioral expressions. Based on the observations made during today’s inspection, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. See LIC809D. An exit interview was conducted and a copy of this report and appeal rights was discussed with and provided to facility representative.the state’s words, verbatim · CDSS document, Mar 23, 2026

The state marks this report as 8 pages; the online copy we transcribed has 5. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

This unannounced inspection is being conducted by Licensing Program Analysts (LPAs) Sean Haddad, Hanna Gough, and Nancy Guillen for the purpose of conducting a Required – 1 Year Inspection. LPAs met with Staff #1 (S1) Deisy Sakul and discussed the purpose of the inspection. Administrator (AD) Nidhi Nandwani arrived during the inspection. LPAs reviewed Infection Control requirements. At about 10:30AM, LPAs and S1 conducted a tour of the inside and outside of the facility, common areas, resident rooms, kitchen, and garage and observed the following: Structure: facility is a 6-bedroom, 3-bathroom, one-story house with a detached garage that is used for storage. There is a back yard with a patio cover for the residents. LPAs and AD observed 1 staff and 3 residents present at the facility. Resident Bedrooms: the 5 resident bedrooms are spacious and will easily accommodate the residents’ furnishings. Furniture for each resident bedroom inspected. Staff Bedrooms: LPAs inspected the one staff bedroom. Bathrooms: the bathrooms were clean, faucets and toilets were operational. Water temperature: tested between 114.6 and 114.7 degrees F in the 2 resident bathrooms. Linens & Hygiene Supplies: new linens and fully stocked linen closets were observed. Emergency Phone Numbers, Exit Plan & Menu: reviewed. Food Service: LPAs observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food is available as required by regulations. Carbon Monoxide, Smoke Detectors, Fire Extinguisher: observed and tested. Appliances: stove burners, microwave, washer, and dryer inspected. Knives: observed locked in the medication cabinet, after corrections. Toxins: observed locked in the garage, after corrections. Medication cabinet: observed to be locked. First-Aid Kit and Activity Supplies: observed and available. Facility’s licensing fees are paid. At about 11:30AM, LPAs reviewed 4 resident files and 3 staff files, interviewed 2 residents and 2 staff, and inspected medications for 4 residents. Facility does not handle resident money. CONTINUED. During the inspection, LPAs and AD observed the following: based on observation and interview, a staff has been living in the accessory dwelling unit (ADU) behind the garage for almost a month, but the ADU has not been fire cleared as a bedroom; based on observation, the facility did not ensure knifes, scissors, pesticides, dishwasher detergent, and other dangerous items were inaccessible to residents whose assessments do not allow for handling of such items; based on Guardian documents and interviews, the licensee did not ensure staff John Ferdinand Senewe observed by LPAs at the facility, who lives at the facility and has worked here for almost a month, was background cleared as their status is pending in Guardian; based on documents, the licensee did not maintain documentation of required training for 2 out of 2 staff; based on observations and admission, the licensee has been administering supplements but does not have doctor's orders for these supplements; and based on documents and admission, the facility did not conduct emergency disaster drills quarterly in 2024 as they only conducted 3 drills in 2024. Based on the observations made during today’s inspection, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. See LIC809D. Immediate civil penalties are being assessed. See LIC421IM, LIC421BG. An exit interview was conducted and a copy of this report and appeal rights was discussed with and provided to facility representative.the state’s words, verbatim · CDSS document, Jan 9, 2025

Allegation investigated: Staff do not ensure resident is spoken to in an appropriate manner Staff handled resident in a rough manner

This unannounced inspection is being conducted by Licensing Program Analysts (LPAs) Sean Haddad and RoseMarie Ruppert for the purpose of investigating the above-mentioned complaint allegations. LPAs met with Administrator (AD) Nidhi Nandwani and explained the reason for today’s inspection. The investigation into the allegations that staff do not ensure resident is spoken to in an appropriate manner and staff handled resident in a rough manner revealed the following: During the course of the investigation, LPAs inspected the facility, interviewed AD, residents, and staff, and obtained and reviewed copies of the resident roster, staff roster, and resident files. CONTINUED Unsubstantiated Regarding the allegation that staff do not ensure resident is spoken to in an appropriate manner: it was alleged that residents were told they could no longer remain at the facility if they continue to be disrespectful to staff and that residents get yelled for requesting assistance. LPAs interviewed four out of four residents and did not obtain information corroborating this allegation. LPAs interviewed two staff and did not obtain information corroborating this allegation. LPAs interviewed AD who denied the allegation. The information obtained did not corroborate the allegation. Regarding the allegation that staff handled resident in a rough manner: it was alleged that residents are being changed aggressively. LPAs interviewed four out of four residents and did not obtain information corroborating this allegation. LPAs interviewed two staff and did not obtain information corroborating this allegation. LPAs interviewed AD who denied the allegation. The information obtained did not corroborate the allegation. Based on the information gathered during the investigation and review of all documents obtained, the Department is unable to ascertain if the above allegations occurred as reported. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove or refute the alleged violations occurred; therefore, these allegation are deemed Unsubstantiated. An exit interview was conducted and a copy of this report was discussed with and provided to facility representative.the state’s words, verbatim · CDSS document, May 7, 2024 · control 22-AS-20240502150109

Type of visit: Case Management - Deficiencies

This unannounced Case Management – Deficiencies inspection is being conducted by Licensing Program Analysts (LPAs) Sean Haddad and RoseMarie Ruppert for the purpose of issuing citations for deficiencies observed during the investigation into Complaint Control No. 22-AS-20240502150109. LPAs met with Administrator (AD) Nidhi Nandwani and discussed the purpose of the inspection. During the course of the investigation, LPAs determined using the Licensing Information System that Staff #1 (S1) Cecilia Buscato is background cleared, but is not associated to facility #306006367 and has been working at the facility for for about three weeks per AD admission. Based on the observations made during today’s inspection, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. See LIC809D. An exit interview was conducted and a copy of this report and appeal rights was discussed with and provided to facility representative.the state’s words, verbatim · CDSS document, May 7, 2024

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87355(e)(2) · Plan of correction due date: May 8, 2024

87355 Criminal Record Clearance (e) All individuals subject to a criminal record review .. shall prior to working, residing or volunteering in a licensed facility: … (2) Request a transfer of a criminal record clearance… This requirement was not met as evidenced by: Based on interviews and documents, the licensee did not ensure S1 was associated to the facility prior to working at the facility, which poses a potential safety risk to persons in care.the state’s words, verbatim · CDSS document, May 7, 2024

Plan of correction: Licensee stated they will associate S1 to the facility and submit proof to LPA by POC due date.

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Dwayne Mason Jr. made an announced inspection to the facility for purpose of conducting a pre-licensing inspection for a change of ownership. LPA arrived at the was greeted and granted entry by designated Administrator (AD) Nidhi Nandwani. An application to operate a Residential Care Facility for the Elderly (RCFE) for (6) capacity, (2) ambulatory, (3) non-ambulatory, and (1) bedridden clients was received by Community Care Licensing (CCL) on 6/21/2023. Structure: The facility is a one-story home with five client bedrooms, two client bathrooms, living room, common area, kitchen, dining room, caregiver room, staff bathroom, detached two car garage, shaded patio and backyard. LPA observed the See Something, Say Something poster (PUB 475) in the facility mounted on the wall in the kitchen. There is a back yard with two exit gates. There is one shaded patio with seating area in the backyard. LPA did not observe any obstructions blocking the exit gates or obstacles or hazards in the backyard. Client Bedrooms: All client bedrooms have the required furnishings. LPA observed all resident beds have linens and blankets. LPA observed all windows were screened. Toxins: LPA observed chemicals, cleaning solutions, laundry toxins and disinfectants are inaccessible to clients and are stored and locked in the garage. Medications, First-Aid Kit & Book: Medication and first aid kit are stored in a closet in the living room.. First aid kit is stored with the medication. The first aid kit has all the required elements. Resident & Staff Files: Records will be locked in the designated caregiver space in the living room.. Component III: Component III was provided to cover information regarding maintaining compliance. Fire Extinguisher: LPA observed the fire extinguisher to be fully charged as indicated by the arrow pointing in the green zone. LPA observed a service tag for the fire extinguisher which indicates the fire extinguisher was last serviced on 7/13/2023 Activities: The facility hosts movie nights, sports nights and game nights for the residents. Fire clearance: Was approved by a fire inspector of Fullerton Fire Department on 8/31/2023. Bathrooms: All bathrooms have working plumbing and designated hand washing posters. Hot water initially measured above 120 degrees Fahrenheit. Staff adjusted hot water heater and LPA waited for the hot water to drain from the tank. LPA measured the water again and observed the hot water to measure 105.2 degrees Fahrenheit in both bathrooms. LPA advised applicant to monitor the water in resident bathrooms since measurements are so close to the minimum. Linens & Hygiene Supplies: A supply of extra linen is stored in cabinets in the hallway and one of the resident bathrooms. Emergency Phone Numbers, Exit Plan & Menu: Posted and available for review. Food Service: There is a supply of 2-day perishable and 7-day of non-perishable food on hand. Smoke Detectors: Smoke detectors and Carbon Monoxide detectors are stationed throughout the home. Both types of detectors were tested and observed to be operational. Appliances: Gas five burner stove with 1 oven, 1 refrigerator, dish washer, microwave, washer, and dryer are operational. The designated AD was notified that the final application approval will be issued by the Centralized Applications Bureau in Sacramento. Exit interview was conducted and a copy of this report was provided to designated AD.the state’s words, verbatim · CDSS document, Dec 27, 2023