Apple Blossom Gardens Residential Care Facility

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA), Cuadra arrived unannounced to conduct an Annual Required Inspection and met with Licensee Josephine Blancaflor. Required postings were observed. Annual fees current. There is one resident receiving hospice services. LPA/staff toured the facility at 9:00 am and made the following observations: Facility was a comfortable temperature and passageways were free from obstructions. Water temperature in resident's bathroom measured at 105.3, 115.7 and 116.2 degrees F which are within regulations. Extra hygiene products and linens were available. Bathrooms had required bath mats and grab bars. Residents were observed participating in activities in common areas. Cabinets containing cleaning supplies and other items that could pose a risk were locked. Facility has at least two days of perishable and one week of non-perishable foods. Medications were centrally stored and locked. Fire extinguisher was last inspected May, 2025. Smoke detectors and Carbon Monoxide detector located throughout the facility were tested and operational. Exit doors have auditory alert system and were functional at time of visit. Last disaster drill conducted on 12/13/25. At approximately 9:15am LPA/staff observed that washcloths were hanging on the bathroom towel bars for resident use in two out of three resident bathrooms that are shared by residents. LPA/staff observed that the bathrooms didn’t have paper towels for resident use to help ensure sanitary hygiene care for all residents. Licensee put paper towels in the bathrooms and LPA explained that regulation states that the use of common wash cloths and towels shall be prohibited. File review was initiated at 9:30am. Three staff files and five resident files were reviewed. Staff have required First Aid and CPR certificates, training records were reviewed. Continue on LIC809C... Continued from LIC809... Residents receiving hospice services had a care plan that appears to be accurate to services being provided. Residents' care plans seems to have a person-centered approach and they are updated. Medical assessments are current and included a description of any known behavioral expression. Administrator Certificate for Licensee Josephine Blancaflor, 6015304740 expires 7/14/26. Medication & records reviewed. At approximately 10:00am, based on records review, resident's (R1) physician report (LIC602) dated 10/17/25 indicates that R1 has a history of pressure injury right heel. Although R1 does not currently have a pressure injury in their right heel, it should be documented and monitored by staff in their care plan. LPA had a conversation with the Licensee regarding the importance to constant monitoring of skin condition due to R1's history (technical violation issued). Also at approximately 10:15am, resident (R2) care plan indicates that they are two people assist, but R2's physician report (LIC602) dated 5/20/25 reveals that R2 has an ambulatory status and needs assistance with activities of daily living. Although R2's physician report does not indicate that R2 needs two people assistance, LPA reviewed current LIC500 Personnel Report does not reflect two staff on duty at night shift. Per Licensee, R2 was at one point needing two people assistance, but as of today, one staff is able to assist R2 with their ADLs including transferring, Licensee have staff on duty demonstrate to LPA that R2 was able to be assisted by only one staff while R2 was in the dining room, staff transfer them to their bedroom using a wheelchair. LPA instructed Licensee to obtain an updated physician report (LIC602) to have R2's physician determine the current status and needs of R2, because clearly R2 had a change of condition that resulted in R2 is no longer ambulatory. At approximately 10:30am, LPA/Licensee observed that staff (S1) did not have a TB tuberculosis test on file in their LIC503 Health Screening form dated 2/11/26. Per Licensee, the health appraisal agency that performed the test have not send them the results. However, Type of TB test performed is not marked on the LIC503 form indicating that the test was done. Licensee submitted updates of the following documents: Designation of Administrative Responsibility (LIC308), Personnel Report (LIC500) and copy of Liability insurance. Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Appeal rights given. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted with Licensee and a copy of this report was given.the state’s words, verbatim · CDSS document, Feb 12, 2026

The state marks this report as 7 pages; the online copy we transcribed has 6. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPAs), Deniz and Cuadra arrived unannounced to conduct an Annual Required Inspection and met with Licensee/Administrator Josephine Blancaflor. Required postings were observed. Annual fees are paid during our visit. LPAs/Licensee initiated a tour of the facility at 9:20 am and made the following observations: Facility was a comfortable temperature and passageways were free from obstructions. Water temperature in resident's bathroom measured at 119.3, 121.4, and 121.8 degrees F which are not within allowable range of 105 to 120 degrees F (Deficiency cited). Extra hygiene products and linens were available. Bathrooms had required bath mats and grab bars. Cabinets containing cleaning supplies and other items that could pose a risk were locked.Facility has at least two days of perishable and one week of non-perishable foods. Medications were centrally stored and locked. Fire extinguisher was last inspected May, 2024. Smoke detectors and Carbon Monoxide detector located throughout the facility were tested and operational. Exit doors have auditory alert system and were functional at time of visit. Last disaster drill conducted on 1/27/25. File review was initiated at 10:00am. Three staff files and five resident files were reviewed. Staff have required First Aid and CPR certificates, training records were reviewed. All resident's files have current medical assessments and care plans. Administrator Certificate for Licensee Josephine Blancaflor, 6015304740 expires 7/14/26. A spot of medications revealed some discrepancies as follow; there was an unrecorded medication Hydrocodone -Acetaminophen 10-325 MG in the medication log for resident (R1) and Tab-A-Vite Tabs Major medication for resident (R2) had a missing information in the centrally stored medication log (Deficiency cited). Licensee submitted updates of the following documents: Designation of Administrative Responsibility (LIC308), Personnel Report (LIC500), Liability insurance and control of property. Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Appeal rights given. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted with Licensee and a copy of this report was given.the state’s words, verbatim · CDSS document, Feb 20, 2025

Allegation investigated: -Staff are restraining resident in care.

Licensing Program Analyst (LPA) Cuadra arrived unannounced to conduct a complaint investigation and deliver findings regarding the above allegations and met with Licensee Josephine Blancaflor. The Department received an allegation of staff are restraining resident in care. Per Reporting party, there was an individual who came to the facility to visit resident (R1), staff (S1) answered the door when S1 recognized the individual, they "looked like a deer in the headlights", immediately turned around and started running into the home, individual ran after S1. S1 had run to where R1 was in their wheelchair and immediately started to take off big, thick belts that were being used to restrain R1 into their wheelchair. S1 said "This is for their safety”. Reporting party ensures that there are no physician's orders for these restraints and that staff should not be doing this. The Reporting Party is very concerned that staff are restraining residents so that they don't have to supervise them as much. LPA conducted an unannounced visit on 8/22/24 and confidential interviews were conducted with Licensee, residents (R1, R2, R3 & R4) and home health nurse. Continues on LIC9099C... Unsubstantiated Continues from LIC9099... Based on interviews, there were no concerns been raised related with care and supervision provided by the facility staff including any incident of restraining residents with belts. During the visit, LPA observed some residents do have belts in their wheelchair and inquired about them. According to interviews conducted with staff (S1 & S2), the belts are used as a tool to assist residents with transfers between their wheelchairs to their beds, they are worn around the waist in conjunction with Hoyer lift and the facility have two staff to provide support to the residents in care. LPA conducted confidential interviews with outside parties, who provided a letter dated 7/17/2023 from R1’s responsible party to facility licensee requesting the facility to don’t allow resident from leaving the facility with other people due to medical reasons and requesting staff to supervise R1 when there are more than two people visiting them due to combative behavior after a couple incidents where R1 was observed acting combative after visits. Per Licensee, they are allowing visitors and providing space for them to have privacy, but they do not allow visitors to take R1 out of the facility as indicated per their physician report. Based on records review, LPA have reviewed R1’s physician’s report dated 7/18/23, where it was revealed that R1 does have a motor impairment that needs assistance with activity of daily living (ADLs) and have a non-ambulatory status. Also, has a history of skin breakdown condition, they are not able to leave facility unassisted with family for medical appointments only. R1’s care plan dated 8/16/24 confirms that they are two people assist with transfers. The facility provided LPA with LIC500 Personnel Record and staff schedule for the month of August 2024 revealed that the facility does have two staff per morning and afternoon shift and one staff for night shift to ensure the safety and well-being of residents with mobility challenges. Based on LPA’s observation, there was no information or concern that could revealed that any of the incidents above mentioned have happened at a prior date. A finding that the complaint allegation of staff is restraining resident in care is unsubstantiated meaning that although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is UNSUBSTANTIATED. No citations during today's visit.the state’s words, verbatim · CDSS document, Oct 17, 2024 · control 21-AS-20240819125034

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA), Cuadra arrived unannounced to conduct an Annual Required Inspection and met with Licensee Jojo Blancaflor. Required postings were observed. Annual fees are current. LPA/Licensee initiated a tour of the facility at 9:00 am and made the following observations: Facility was a comfortable temperature and passageways were free from obstructions. Resident rooms were furnished per regulation. Water temperature in resident's bathroom measured at 119.3, 105.6 and 106.7 degrees F which are within allowable range of 105 to 120 degrees F. Extra hygiene products and linens were available. Bathrooms had required bath mats and grab bars. Cabinets containing cleaning supplies and other items that could pose a risk were locked. Facility has at least two days of perishable and one week of non-perishable foods. Medications were centrally stored and locked. Fire extinguisher was last inspected July, 2023. Smoke detectors and Carbon Monoxide detector located throughout the facility were tested and operational. Exit doors have auditory alert system and were functional at time of visit. Last disaster drill conducted on 1/5/24. File review was initiated at 9:30am. Four staff files and six resident files were reviewed. Staff have required First Aid and CPR certificates, training records were reviewed. All resident's files have current medical assessments and care plans. Administrator Certificate for Licensee Josephine Blancaflor, 6015304740 expires 7/14/24. Medications and medication records were reviewed. Licensee submitted updates of the following documents: Designation of Administrative Responsibility (LIC308), Personnel Report (LIC500), Liability insurance, control of property and Emergency Disaster Plan (LIC610E) if there are any changes. No deficiencies during today's visit. Exit interview conducted with Licensee and a copy of this report was given.the state’s words, verbatim · CDSS document, Feb 12, 2024