Blissful Canyon Homecare

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Yolanda Delgado arrived unannounced to conduct an annual inspection. Upon arrival LPA was greeted by facility staff and granted entry by Enrick Aposaga. LPA began inspection with introduction, visit purpose and provided the facility caregiver with LPA identification and business card. Resident record review began- Six (6) records were reviewed. LPA reviewed for admission agreement, medical assessment and TB test results, consent forms, identification and emergency information, appraisal needs and service plans, centrally stored medication/destruction records, safeguard for personal property/valuables, and personal rights notification. This facility is meeting documentation requirements. Physical Plant and Safety of Environment/Operational Requirements- LPA toured the facility inside and outside. The home is maintained at a comfortable temperature for the clients. Lighting is sufficient for safety and comfort. Water temperature measured 117.0 degrees F. Laundry facilities and a locked cabinet is present for storing laundry soap and other chemicals. All outdoor and indoor passageways are free of obstruction. A locked area is provided for medications and sharp objects. LPA verified there is a telephone working at this location. Food Service- Food supply meets the requirement of one week supply of nonperishable and 2 day supply of perishables food on hand. Foods are dated to assure safety. Food prep areas are clean and organized. (Continued on page 2) (Continued from Page 1) LPA began review of employee records- Three (3) records were reviewed. LPA reviewed employee record for first aid certification, fingerprint clearance, personnel/job application, health screening and TB test results, criminal record statement, employee rights, training verification, and current administrator certification. CPR and requirements have been met. The facility employs enough staff to maintain cleanliness and meet the needs of the clients in care. Administrator certification is present and current. LPA made observation throughout the inspection process to assess if the facility remains in conformity with the State Fire Marshall regulations. The facility has not exceeded its capacity limitation and the structure has not been changed. Smoke detectors and carbon monoxide detectors were tested and found to be operational. Fire extinguishers are tested or replaced annually and were last done so on 12/30/2025. The facility is conducting emergency disaster drills. The last disaster drill was conducted on 12/29/2025. There are no firearms stored at the facility and there is a pool with a black mesh barrier fencing surrounding the exterior of the pool. Based on the information received during this visit today, there will be one (1) Technical Violation (TA) issued per Title 22, Division 6 of The California Code of Regulations. This report, TA was reviewed with Rosalinda Orleans and a copy provided at the time of the exit interview.the state’s words, verbatim · CDSS document, Jan 30, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Yolanda Delgado arrived unannounced to conduct an annual inspection. Upon arrival LPA was greeted by facility staff and granted entry. LPA began inspection with introduction, visit purpose and provided the facility caregiver with LPA identification and business card. Resident record review began- Five (5) records were reviewed. LPA reviewed for admission agreement, medical assessment and TB test results, consent forms-2 missing, identification and emergency information, appraisal needs and service plans-1 missing, centrally stored medication/destruction records, safeguard for personal property/valuables, and personal rights notification. This facility is is not meeting documentation requirements. Physical Plant and Safety of Environment/Operational Requirements- LPA toured the facility inside and outside. The home is maintained at a comfortable temperature for the clients. Lighting is sufficient for safety and comfort. Water temperature measured 117.0 degrees F. Laundry facilities and a locked cabinet is present for storing laundry soap and other chemicals. All outdoor and indoor passageways are free of obstruction. A locked area is provided for medications and sharp objects. LPA verified there is a telephone working at this location. Food Service- Food supply meets the requirement of one week supply of nonperishable and 2 day supply of perishables food on hand. Foods are dated to assure safety. Food prep areas are clean and organized. LPA began review of employee records- Five (5) records were reviewed. LPA reviewed employee record for first aid certification, fingerprint clearance, personnel/job application, health screening and TB test results, criminal record statement, employee rights, training verification, and current administrator certification. CPR and requirements have been met. The facility employs enough staff to maintain cleanliness and meet the needs of the clients in care. Administrator certification is present and current. (Continued on next page) (Continued on from Page 1) LPA made observation throughout the inspection process to assess if the facility remains in conformity with the State Fire Marshall regulations. The facility has not exceeded its capacity limitation and the structure was changed in 2022 and LIC809 dated 2/15/2022 noted that facility is under renovations however no updated floor plan and no updated STD. 500 (family/living room was renovated to rooms for residents) was observed in facility's file. Smoke detectors and carbon monoxide detectors were tested and found to be operational. Fire extinguishers are tested or replaced annually and were last done so on 01/04/2025. The facility is conducting emergency disaster drills. The last disaster drill was conducted on 11/20/2024. There are no firearms stored at the facility and there is a pool with a black mesh barrier fencing surrounding the exterior of the pool. LPA allocated time to prepare this report for delivery. Based on the information received during this visit today, there are two (2) deficiencies are being cited per Title 22, Division 6 of The California Code of Regulations. This report, LIC809D, Appeal Rights was reviewed with and a copy provided to the facility representative at the time of the exit interview. LPA has requested the Licensee to complete and submit LIC200 and updated floor plan to CCLD by 1/31/2025the state’s words, verbatim · CDSS document, Jan 24, 2025

Allegation investigated: Licensee accused resident of making several complaints. Facility not following COVID safety protocols.

Licensing Program Analyst, (LPA) Kathleen Banrasavong conducted an unannounced visit to deliver findings for a complaint investigation regarding the above allegations. LPA met with Administrator, Linda Orleans and LPA explained the purpose of the visit and the elements of the allegations. The investigation consisted of observation, interviews with staff members and residents, and records review. On 12/10/2021, Community Care Licensing received a complaint alleging Licensee accused resident of making several complaints, facility not following COVID safety protocols. It was reported that the facility accused Resident #1 (R1) of making several complaints. LPA interviewed Administrator, Linda Orleans regarding the allegations. Administrator stated she never accused R1 of making several complaints to the department. Administrator stated residents have the right to make complaints. Unsubstantiated LPA was unable to interview R1 due to R1 not living at the facility as of January 1, 2022. LPA was unable to obtain contact to interview R1. The initial visit made by a previous LPA was not able to confirm or deny this allegation with any staff members or residents, during the time frame of complaint in 2021. In regards to the allegation that the facility did not follow COVID safety protocols, LPA interviewed Administrator who stated that the facility did not have any COVID 19 residents or outbreaks at the facility, because they always took precautious seriously. LPA reviewed the migration and infection control plan and observed adequate PPE equipment. LPA was unable to interview R1 due to R1 relocation and unable to obtain contact. Current residents and staff were not at the facility during the time frame of this initial complaint investigation. Based on LPA’s observation, interviews conducted, and record review, the allegations that Licensee accused resident of making several complaints, facility not following COVID safety protocols is unsubstantiated due to the inability to interview pertinent parties. A finding of unsubstantiated means the allegations may have happened or is valid, but there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur. Therefore, the allegations are unsubstantiated. An exit interview was conducted, and a copy of this report was discussed with and provided to the Administrator, Linda Orleans.the state’s words, verbatim · CDSS document, Jul 29, 2024 · control 18-AS-20211210152136

Allegation investigated: Licensee has failed to report the facility closure to the Department.

Licensing Program Analyst, (LPA) Kathleen Banrasavong conducted an unannounced visit to deliver findings for a complaint investigation regarding the above allegations. LPA met with Administrator, Linda Orleans and LPA explained the purpose of the visit and the elements of the allegations. The investigation consisted of observation, interviews with staff members and residents, and records review. On 12/10/2021, Community Care Licensing received a complaint alleging Licensee has failed to report the facility closure to the Department. Unfounded In regards to the allegation that Licensee has failed to report the facility closure to the Department, it was reported that the facility underwent a renovation and did not provide proper notification. LPA requested records of email correspondence and documentation pertaining to the facility. Licensee provided the information to the Department and resident’s 30-day eviction notices. LPA reviewed the 30-day eviction notices and signature from the 2 residents confirming the receipt of the document. Licensee stated that notice to the Department was provided on November 2, 2021. The assigned LPA at that time, confirmed the notice of the closure. This allegation is unfounded. Based on LPA’s observation, interviews conducted, and record review, the allegations that Licensee has failed to report the facility closure to the Department is unfounded.This agency has investigated the complaint alleging Licensee has failed to report the facility closure to the Department. We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. An exit interview was conducted, and a copy of this report was discussed with and provided to the Administrator, Linda Orleans.the state’s words, verbatim · CDSS document, Jul 29, 2024 · control 18-AS-20211210152136

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Janira Arreola conducted a required annual visit. LPA was greeted and was granted entry and met with Administrator, Rosalinda Orleans, who was informed of the purpose of the visit. At time of visit there were (6) clients and (3) staff present. The facility is a one story home with (5) bedrooms and (2) bathrooms with attached garage. The facility does have a pool with a surrounding locked gate. No fire arms are kept at the facility. The facility is a residential care facility for the elderly serving elderly ages 60 and above. LPA observed the following: Infection Control: LPA observed hand hygiene supplies, PPE equipment and cleaning supplies to do regular cleaning of the facility. The facility has a infection control plan on file and staff training. Physical Plant: Physical plant, floors, windows, and doors were observed to be clean and fixtures and furniture were present and in good repair. The facility's outdoor area was observed to be free of hazards. Laundry equipment was observed to be in good working condition. The carbon monoxide detector was tested and operational during the visit. Food Service: LPA observed facility kitchen had the ability to prepare food in clean environment and possessed equipment in good working condition. LPA observed the facility met the required food items, and provisions for modified diets. Record Review and Resident/Staff Files: LPA reviewed staff files and training along with CPR/First Aid. Client files were reviewed and possessed all required paperwork, except for (1) client file which did not have an updated LIC602. Technical note was documented and staff made arrangements to obtain a copy. Health Related Services/ Incidental Medical Services: All client medication was locked in a hallway cabinet. LPA reviewed client medications and found that MARS and medication was accounted for and had required labeling. Disaster preparedness: LPA reviewed the facility's emergency and disaster plan. LPA reviewed documentation showing last fire drill conducted on 12/26/2023 The documentation did not meet the department standards and technical note was documented. No deficiencies were cited at the time of the visit. An exit interview was conducted where a copy of this report was reviewed and provided to, Administrator, Rosalinda Orleansthe state’s words, verbatim · CDSS document, Jan 23, 2024

The state marks this report as 4 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.