Bluegarden Care

Type of visit: Case Management - Annual Continuation

On 10/31/2023 at 9:25 AM, Licensing Program Analyst (LPA) J. Sampair arrived unannounced for an annual inspection continuation visit. Upon entry into the facility, LPA explained the purpose of the visit to Caregivers Carleen Sablan and Carline Skang. Licensee Yanlin "Cynthia" Huang arrived at approximately 10:00 AM. During the Inspection, the LPA reviewed facility records. 1 Type-A and 5 Type-B citations issued (for details refer to LIC809-D). Annual inspection incomplete. LPA will return unannounced at a future date and time. Exit interview conducted with Licensee. A copy of the Appeal Rights and this report provided to Licensee via email.the state’s words, verbatim · CDSS document, Oct 31, 2023

Type of visit: POC

On 10/31/2023 at 9:25 AM, Licensing Program Analyst (LPA) J. Sampair conducted a Plan of Correction (POC) inspection. Upon entry into the facility, LPA explained the purpose of the visit to Caregivers Carleen Sablan and Carline Skang. Licensee Yanlin "Cynthia" Huang arrived at approximately 10:00 AM. This visit was prompted by the citations from the 10/17/2023 annual inspection continuation visit. The Licensee had provided documentation of the correction of some of those citations. However, the Licensee had failed to provide documentation to the LPA that all of the citations had been corrected. During the visit, the LPA verified corrections of 11 out of 19 total citations. For those citations that had not been corrected, the Licensee incurred a total of $5,600 in fines. A civil penalty of $100 per violation per day shall be assessed until the violations are corrected. Exit interview conducted with Licensee. A copy of the Appeal Rights and this report provided to Licensee via email.the state’s words, verbatim · CDSS document, Oct 31, 2023

Allegation investigated: Facility did not provide a copy of resident's admission agreement to resident's authorized representative

On 10/30/2023 at 11:15AM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a complaint investigation and deliver findings in regards to the allegation above. LPA met with caregiver, Carleen Sablan and informed her the reason for visit. Administrator, Cynthia Huang arrived 45 minutes later. During the course of investigation, LPA interviewed 2 residents and 2 staff. LPA obtained and reviewed R1's admission agreement. Interview with staff revealed that a copy of the admission agreement was not given to resident/authorized representative because they did not request for a copy. Based on LPA's information obtained during investigation, the preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, are being cited on the attached LIC 9099D. Exit interview conducted. A copy of this report and appeal rights provided. Substantiatedthe state’s words, verbatim · CDSS document, Oct 30, 2023 · control 15-AS-20231023113701

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87507(e) · Plan of correction due date: Nov 10, 2023

Admission Agreements. The licensee shall provide a copy of the signed ...admission agreement ...immediately upon signing the admission agreement... This requirement is not met as evidence by: Based on investigation, licensee did not comply with the section cited above by not providing a copy of the admission agreement to resident which poses a potential health and safety risk to the persons in care.the state’s words, verbatim · CDSS document, Oct 30, 2023

Plan of correction: Administrator has agreed to provide a copy of the admission agreement to resident and review regulation regarding admission agreement. Administrator will submit self-certification by POC date.

Type of visit: Case Management - Annual Continuation

On 10/17/2023 at 9:00 AM, Licensing Program Analyst (LPA) J. Sampair arrived unannounced to conduct an annual inspection. Upon arrival, LPA explained the purpose of the visit to Caregivers Carleen Sablan and Carline Skang. Administrator (ADM) Yanlin "Cynthia" Huang arrived at approximately 10:15 AM. During the Inspection, the LPA inspected the facility inside and outside. LPA reviewed the records of 3 residents. LPA observed that the facility has a sufficient supply of food: 2 days perishable and 7 days nonperishable. A comfortable inside temperature of 70.4 degrees F was maintained. The facility was clean and the staff attentive to residents' needs. 2 Type-A and 17 Type-B citations issued (for details refer to LIC809-D). Annual inspection incomplete. LPA will return unannounced at a future date and time. Exit interview conducted with ADM and a copy of this report provided via email.the state’s words, verbatim · CDSS document, Oct 17, 2023

Allegation investigated: Staff left residents in soiled diapers for an extended period of time causing residents to sustain sores. Staff does not feed residents in a timely manner. Staff does not bathe residents in a timely manner.

On 10/09/2023 at 10:30 AM, Licensing Program Analyst (LPA) J. Sampair arrived unannounced to conduct the initial 10-day complaint investigation of the allegations above. Upon entry, LPA informed Caregiver Evelia Galvan of the purpose of the visit, who informed Administrator (ADM) Yanlin "Cynthia" Huang. ADM arrived at approximately 11:15 AM. During the visit, LPA reviewed facility and resident records, and interviewed 1 resident, 1 staff member, and ADM. Staff left residents in soiled diapers for an extended period of time causing residents to sustain sores. Based on the records review, interviews with residents and staff, there was no data supporting this allegation. (Continued on LIC9099-C...) Unsubstantiated (...Continued from LIC9099) Staff does not feed residents in a timely manner. Based on the records review, interviews with residents and staff, there was no data supporting this allegation. Staff does not bathe residents in a timely manner. Based on the records review, interviews with residents and staff, there was no data supporting this allegation. Although the allegations may have happened, or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED. Exit interview was conducted with ADM. A copy of this report was provided via email.the state’s words, verbatim · CDSS document, Oct 9, 2023 · control 15-AS-20231002101429

Type of visit: Required - 1 Year

On 10/09/2023 at 10:30 AM, Licensing Program Analyst (LPA) J. Sampair arrived unannounced at facility for complaint investigation and added the required annual inspection when complaint investigation completed. Upon entry, LPA informed Caregiver Evelia Galvan of the purpose of the visit, who informed Administrator (ADM) Yanlin "Cynthia" Huang. ADM arrived at approximately 11:15 AM. During the visit, LPA reviewed facility and resident records, and interviewed 1 resident, 1 staff member, and ADM. 1 Type-A citation issued during the inspection (details in LIC809-D) and Civil Penalty of $200 (details in LIC421-BG). Annual inspection incomplete. LPA will return unannounced to complete the inspection. Exit interview conducted with Licensee and a copy of this report was provided via email.the state’s words, verbatim · CDSS document, Oct 9, 2023

Type of visit: Required - 1 Year

On 5/20/2022 at 2:35 PM, Licensing Program Analyst (LPAs) L. Francisco and K. Nguyeb arrived unannounced to conduct Infection Control Inspection. LPAs met with Administrator, Yanlin "Cynthia" Huang and explained the purpose of the visit. During the Infection Control Inspection, LPA toured facility with Admnistrator including but not limited to front entrance, screening station, hand washing stations, bedrooms, common areas, kitchen and backyard. Facility has a sufficient 2-day perishable and one week non-perishable food supply. There is one central entry point for universal screening for staff, residents and visitors. A sign-in policy, thermometer and hand sanitizer were observed at screening station. Common touched surfaces are disinfected at least once daily. Bathrooms are equipped with liquid soap, paper towel and trash bin with touchless lids. Facility has a 30-day supply of PPEs maintained at central location and easily accessible for staff. Facility has a mitigation plan and maintains record of routine screening for residents and staff. THE FOLLOWING DEFICIENCIES WERE OBSERVED: At 2:38 PM, LPAs were not screened at the front main entrance At 2:45 PM, LPAs observed medication cabinet unlocked in the garage At 2:51 PM, LPAs observed unlocked knives inside kitchen cabinet. At 2:53 PM, LPAs observed unlocked medication inside the kitchen island drawer At approximate;y 2:55 PM, LPAs observed two visitors were not screened and temperature was not checked At 2:58 PM, LPAs observed Lysol and Fabuloso inside the centrally stored medication closet At: 3:30 PM, Personnel records are not being maintained at facility At 3:35 PM, LPAs observed a special vistor was not screened and temperature was not taken REPORT CONTINUES ON 809C Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 5/27/2022: LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Liability Insurance Current Administrator’s Certificate The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22. Failure to correct deficiencies by POC date may result in additional Civil Penalties. Exit interview conducted. Appeal Rights and a copy of this report provided.the state’s words, verbatim · CDSS document, May 20, 2022

The state marks this report as 9 pages; the online copy we transcribed has 5. You can request the full file from the county licensing office.