Blissful Canyon Homecare 3

Type of visit: Required - 1 Year

On August 26, 2026, Licensing Program Analyst (LPA), Jarred Torres, arrived at the facility unannounced to conduct an annual inspection. LPA met with Caregiver, Angelita Pastor, explained the purpose of the visit and inspected the facility. A facility file review was conducted at the regional office and additional records were requested and reviewed at the facility. The facility is licensed for six residents and was operating at a census of five. Administrator, Danielle Orleans, gave Angelita permission to sign the licensing report in their absence. LPA toured the facility along with Angelita, and made observations pertaining to the annual inspection. LPA inspected the facility inside and outside. There were no obstructions to the indoor and outdoor passageways at the time of this visit. During the tour of the premises, LPA observed the facility's phone to be operational. The facility's phone number is 951-215-0143. The LPA observed the residents' bedrooms which were equipped with the required furniture as stated in Tittle 22 of the California Code of Regulations (CCR). The furniture in all areas of the facility was observed to be in good condition. The facility's appliances were observed to be operational at the time of this visit. Required postings regarding safety, personal rights, and emergency exits were posted in the home. Sharp items were kept locked and inaccessible to the residents in care. The facility's cooling and heating system is operational and the air temperature was at 75 degrees Fahrenheit (F) and the hot water was measured at 120 degrees F. Continued on LIC 809-C... LPA observed the medications to be locked and inaccessible to the residents in care. The medication supply was sufficient for their current census. There were no discrepancies with the centrally stored medications. In the kitchen, the food supply of non-perishable and perishable foods consisted of, but not limited to, bread, frozen meats, vegetables, water, eggs, juice, potatoes, salad, snacks, and fruits. The facility goes grocery shopping once per week to maintain an appropriate food supply for the residents. The facility has a designated area for storing activity supplies, and activities are conducted inside and outdoors. Telephone numbers and floor plans were posted in the facility. Client files and staff files were reviewed and no deficiencies were observed. The files were securely stored. The administrator had a valid administrator's certificate on file. LPA reviewed the emergency disaster plan and fire clearance. The last emergency drill was on March 3, 2026. The fire alarms and carbon monoxide detectors were tested and operational. The fire extinguisher was in good condition and were purchased on December 30, 2026. The emergency disaster plan meets the department's standards. LPA inspected the bathrooms and observed the hand washing stations to be stocked with soaps, bath tissue, and single-use hand towels. Furthermore, the bathrooms are free of dust and debris. Additionally, the facility had an approved infection control plan in their files. During this annual inspection, LPA did not observe any health, safety, or personal rights risks to residents in care. An exit interview was conducted and this report was reviewed and provided to Caregiver, Angelita Pastor, whose signature on this form confirms receipt.the state’s words, verbatim · CDSS document, Aug 26, 2026

Type of visit: Case Management - Licensee Initiated

Licensing Program Analyst (LPA), Yolanda Delgado conducted an unannounced case management visit in regards to a capacity increase request. The LPA met with Jelita Pastor. The facility is currently licensed for four (4) ambulatory clients, age 60 and over. The licensee is requesting to increase the capacity from four (4) ambulatory clients to six (6) non ambulatory clients. An approved STD 850 dated March 6, 2025 from the Riverside County Fire Department was submitted to Community Care Licensing for the increase in capacity and updated form with a notation regarding the garage is for storage space only, not permissible for sleeping space was received April 9, 2025. The home consists of five (5) client bedrooms, two and half (2.5) bathrooms, a family room, a kitchen and dinning areas, a laundry and garage area, and outdoor space with shade and seating. The LPA toured the interior and exterior areas of the home. The home was clean and free of debris, the furnishings are suitable for clients. The client bedrooms are all equipped with the required furniture, and closet space, the kitchen was stocked with perishable and non perishable food items, and eating utensils to accommodate the six (6) clients. The medications will be centrally stored and locked in a medicine cart, all toxins were locked and inaccessible to clients. The LPA observed a first aid kit to be available. The LPA observed the required forms, and postings in the facility common areas. This report was reviewed with Jelita Pastor and a copy was provided at the time of the exit interview.the state’s words, verbatim · CDSS document, May 7, 2025

Type of visit: Case Management - Licensee Initiated

Licensing Program Analyst (LPA), Yolanda Delgado conducted an unannounced case management visit in regards to a capacity increase request. The LPA met with Administrator, Rosalinda Orleans. The facility is currently licensed for four (4) ambulatory clients, age 60 and over. The licensee is requesting to increase the capacity from four (4) ambulatory clients to six (6) non ambulatory clients. An approved STD 850 dated March 6, 2025 from the Riverside County Fire Department was submitted to Community Care Licensing for the increase in capacity. The home consists of five (5) client bedrooms, two and half (2.5) bathrooms, a family room, a kitchen and dinning areas, a laundry and garage area, and outdoor space with shade and seating. The LPA toured the interior and exterior areas of the home. The home was clean and free of debris, the furnishings are suitable for clients. The client bedrooms are all equipped with the required furniture, and closet space, the kitchen was stocked with perishable and non perishable food items, and eating utensils to accommodate the six (6) clients. The medications will be centrally stored and locked in a medicine cart, all toxins were locked and inaccessible to clients. The LPA observed a first aid kit to be available. The LPA observed the required forms, and postings in the facility common areas. There was a room observed on the left interior of the garage with a door, enclosed with walls, ceiling light, electrical outlets, floor lamp, small lamp, toiletry supplies, blow dryer plugged into the electrical outlet, with personal belongings, clothing hanging on a stand, two dressers, rolled up mat with linen, pillows, tool boxes, small ladder, grey laundry basket, inside the garage during today's visit. The room is not on the facility sketch. A new license will be not be generated at this time and LPA will need to return to complete the inspection for increase in capacity when a new sketch and a new STD 850 is received to ensure room is in compliance with the Fire Department. This report was reviewed with Administrator Rosalinda Orleans and a copy was provided.the state’s words, verbatim · CDSS document, Mar 28, 2025

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Yolanda Delgado conducted an announced visit to the facility for purpose of a Pre-Licensing evaluation. At approximately 1:35 PM, LPA met with Licensee/Administrator Rosalinda Orleans. An initial application to operate a Residential Care for the Elderly facility (RCFE) was submitted to the Central Applications Bureau (CAB) on 5/2/2024 for a total capacity of four (4); three (3) non-ambulatory and one (1) ambulatory residents. Fire clearance was granted on 5/16/2024. LPA Delgado observed the following: Structure: Facility was a one-story house with four (4) resident bedrooms, one and half (1.5) resident bathrooms, staff room, living room, dining area and kitchen. There was an attached three car garage in the front of the house. Heating/Cooling System: Central heating and air conditioning system installed with a central panel located in the hallway to control entire house. Bedrooms: Each resident bedroom #2, #3 and #4 will accommodate any non-ambulatory resident, bedroom #1 will accommodate one ambulatory residents. Four (4) resident bedrooms were adequately furnished with bed, chair-3 missing, closet, appropriate linens, adequate lighting, and an operable smoke alarm. (Continued on Page 2) (Continued from Page 1) Bathrooms: The one and half (1.5) resident bathrooms has a working toilet, wash basin, and shower with an adequate supply of paper towels, toilet paper, and soap. At 2:20 PM, LPA tested the water temperatures in the resident bathrooms. LPA verified water temperature was measured at 118.3 degrees Fahrenheit. Kitchen/Laundry: An adequate supply of dishes, glasses, utensils, pots and pans were observed. Knives/sharp instruments were secured in a locked drawer located in the garage. There was adequate room for food storage. LPA observed the stove to be operational. Refrigerator/freezer were in working condition, washer and dryer was located inside the garage. Laundry detergents and cleaning supplies were observed in garage away from residents. Living/Family room: There was a living/family room with furniture for all clients and TV. Linens and Hygiene Supplies: An adequate supply of linens was stored in each resident rooms and hygiene supplies will be stored inside the garage Yards/Outside: Patio table, chairs and shade were observed in the backyard. There was a gate on the South side and North side of the property with a self-latching door. All outdoor pathways were free of obstructions. LPA observed a spa with secured cover however it was not on the facility sketch. Emergency Phone Numbers, and Exit Plan: Facility sketch and Let-Us-No poster were observed posted in the main hallway. Exit plans observed at exits. (Continued on Page 3) (Continued from Page 2) General items: One (1) fire extinguishers were charged and located in the kitchen. Six (6) smoke alarms and one (1) carbon monoxide detectors were tested and were observed to be in working order. Client records will be stored in a locked medicine cabinet. First Aid kit with required components, and locked area for medication storage was observed. LPA observed a facility phone and it was verified to be operational as evidenced by LPA dialing the number to trigger a ring. Emergency water supply was observed however the required 72-hour emergency food supply was not discernible from the regular food supply. Component III will be completed on July 25, 2024 at Riverside RO. Pre-Licensing is incomplete and the following corrections to be resolved by 7/15/2024: obtain a separate 72-hour emergency food supply obtain and post visiting policy obtain and post Obudsman Poster obtain and post Discrimination notice obtain PPE supplies obtain a boxspring for resident room #4 obtain chairs for rooms #2, #3, #4 post emergency telephone numbers submit facility sketch to CAB with update for backyard that includes spa & fire pit submit updated dementia care plan to CAB to include spa An exit interview was conducted with Rosalinda Orleans and a copy of this report was given.the state’s words, verbatim · CDSS document, Jul 8, 2024