Blessed Garden Home

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) E. Conchas made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA met with Facility caregiver Rose Manlolo aka Rosalinda and was granted entry to the facility. At the time of the visit there was two (2) staff present, and six (6) residents present. The facility is a Residential Care Facility for Elderly (RCFE) Licensed capacity is six (6). The facility is a four (4) bedroom, two (2) bathroom home, with a kitchen/dining area, living room and an attached garage. The LPA was accompanied by caregiver Rosalinda to conduct a general overall inspection. The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature of 74 degrees F. The facility is equipped with operating smoke detectors and carbon monoxide alarms. Posters such as personal rights, the CCL complaint poster, LTCO, infection control plan, facility sketch, administrator license and the disaster plan were posted in a common area. LPA inspected residents’ bedrooms which are equipped with required furniture, storage space, and sufficient lighting. The bathrooms were clean, and appliances were operating appropriately. Water temperature in the restrooms was measured at 110 degrees F. LPA observed sufficient furniture and lighting throughout the facility. LPA observed the kitchen. There was sufficient Non-perishable and perishable food supply for number of residents in care. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to residents in care. Continue to LIC809-C There was a designated storage space for resident/staff files. LPA reviewed resident files for admission agreements, updated physician reports, and needs and services plans. Medications are kept inside medication closet inaccessible to residents in care. Medications were audited at random and appeared to be dispensed appropriately by staff members. LPA also reviewed staff files for First Aid/CPR certification, criminal record clearance, training, and health screenings. Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. All staff members working in the facility have criminal record clearance through the department. Overall, the facility is clean and in good repair. The following was observed and citations were issued · Staff 3 did not have copy of current CPR in file. · Medication was observed in the refrigerator accessible to clients. · Emergency disaster plan was not updated. · Infection control was not updated Based on the observations made during today’s visit, deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report was discussed and will be provided to Caregiver Rosalinda.the state’s words, verbatim · CDSS document, Sep 17, 2026

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87411(c)(1) · Plan of correction due date: Oct 1, 2026

(c) All RCFE... (1) Staff providing care shall receive appropriate training in first aid from persons qualified by such agencies as the American Red Cross. This requirement is not met as evidenced by: LPA observed S3 works night shift. LPA observed no copy of current CPR on file which poses a potential health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Sep 17, 2026

Plan of correction: Licensee to ensure there is atleast one staff per shift with current CPR to provide care. . Provide a copy of completion to LPA by POC date

From the deficiency page — Deficiency type: Type B · Section cited: CCR87465(h)(2) · Plan of correction due date: Oct 1, 2026

87465(h)(2)Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication. This requirement is not met as evidenced by: LPA observed R1 insulin medication in the refrigerator accessible to any persons other than employees which poses a potential health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Sep 17, 2026

Plan of correction: Licensee to ensure any required refrigerated medication is locked and not accessible to persons other than employees responsible. . Provide an update upon correction to LPA by POC date

From the deficiency page — Deficiency type: Type B · Section cited: HSC 1569.695(d) · Plan of correction due date: Oct 1, 2026

(d) A facility shall review the plan annually and make updates as necessary,including changes in floor plan and the population served... sign and date documentation to indicate that the plan has been reviewed and updated as necessary.This requirement is not met as evidenced by: LPA observed emergency disaster plan has not been signed off for review since 1/19/2024 which poses a potential health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Sep 17, 2026

Plan of correction: Licensee to review the Emergency disaster plan, update it if needed. Train staff and maintain requirments according to regulations. Provide a copy of completion to LPA by POC date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87470(c)(1)(D) · Plan of correction due date: Oct 1, 2026

(D)The licensee shall review the use of infection control procedures in the facility at least annually, if local government public health determines an epidemic outbreak has occurred, or if the review is requested by the local licensing agency. This requirement is not met as evidenced by: LPA observed infection control plan has not been signed off for review since 03/9/2025 which poses a potential health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Sep 17, 2026

Plan of correction: Licensee to review the Infection control plan, update it if needed. Train staff and maintain requirments according to regulations. Provide a copy of completion to LPA by POC date

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Paola Guerrero made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA met with Facility Administrator Lariza Ramos and was granted entry to the facility. At the time of the visit there was two (2) staff present, and six (6) residents present. The facility is a four (4) bedroom, two (2), bathroom home, with a kitchen/dining area, living room, with an attached garage. The facility is a Residential Care Facility for Elderly (RCFE) Licensed capacity is (6) current census (6). LPA was accompanied by Facility Administrator, to conduct a general overall inspection, which included, but was not limited to, the following: Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature. LPA inspected resident’s bedrooms; they are equipped with required furniture such as: mattresses, nightstands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA observed sufficient furniture and lighting throughout the facility. The facility is equipped with operating smoke detectors and carbon monoxide alarms. Posters such as personal rights, the CCL complaint poster, and the disaster plan were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to residents in care. There was a designated storage space for resident/staff files. Medications are kept inside medication closet inaccessible to residents in care. Overall, the facility is clean, in good repair, and operating in safe conditions for residents in care. Food Service: Non-perishable and perishable food supply is sufficient for number of residents in care. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. All staff members working in the facility have criminal record clearance through the department. Record Review: LPA reviewed three (3) resident files for admission agreements, updated physician reports, and needs and services plans. LPA also reviewed three (3) staff files for First Aid/CPR certification, criminal record clearance, training, and health screenings. Medications were audited at random and appeared to be dispensed appropriately by staff members. Based on the observations made during today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809) was discussed and provided to Facility Administrator Lariza Ramos.the state’s words, verbatim · CDSS document, Oct 31, 2025

Allegation investigated: Staff did not properly handle a deceased resident while in care.

Licensing Program Analyst (LPA) Bernadette Allen made an unannounced visit to the facility to conduct a complaint investigation and deliver the findings. LPA Allen introduced herself and explained the purpose of the visit and the allegation to Alvin Ramos, the Licensee. The investigation consisted of interviews with staff members, file review, and observations. LPA interviewed staff members who reported that Resident 1 (R1) had passed away at the facility over the weekend. LPA reviewed documents indicating that the licensee complied with Community Care Licensing Division reporting requirements according to regulations. The files reviewed also showed that the deceased resident was appropriately handled while in care. LPA reviewed additional documents confirming the transportation company used to transport R1 from the facility. During the tour of the facility, LPA found no health and safety concerns. Unfounded Based on interviews and evidence gathered during the investigation, the above allegation is found to be Unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. An exit interview was conducted where this report was discussed and provided to Alvin Ramos- Licensee at the conclusion of the visit with appeal rights.the state’s words, verbatim · CDSS document, Dec 10, 2024 · control 56-AS-20241210090930

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Bernadette Allen and Renese Howell-Small conducted an announced visit to the facility for the purpose of a Pre-Licensing evaluation to operate a Residential Care Facility for the Elderly (RCFE) for a total capacity of 6 non-ambulatory residents. LPA's met with Lariza Holcomb Ramos-Administrator . LPA's Allen and Small observed the following: Structure: Facility is a single-story home with four (4) bedrooms and two (2) bathrooms, one (1) bathroom is in the master bedroom, and one (1) bathroom is located in the main hallway. There is a living room, dining area, and kitchen. Heating/Cooling System: Central heating and air conditioning systems. Bedrooms: All bedrooms were adequately furnished with bed, chair, large closets, appropriate linens, adequate lighting, and an operational smoke alarm and fire extinguishers. Bathrooms: Bathrooms have a working toilet, wash basin, and shower with handrails and non-slip mats. There was an adequate supply of towels, toilet paper, and toiletries. Water temperature measured at 105- 111 degrees F. Kitchen/Laundry: An adequate supply of dishes, glasses, utensils, pots and pans were observed. Cleaning supplies and knives/sharp instruments were secured in a locked cabinet and/or drawer. There was adequate room for food storage. Refrigerator/freezer were in working condition. There was adequate seating for meals. The washer/dryer and cleaning supplies were locked in the garage. Living/Family room: Furnished with safe and adequate seating and furnishings. All items appear to be in good repair. Linens and Hygiene Supplies: An adequate supply of linens was available for the clients in care. Yards/Outside: There was a covered area with adequate seating for staff and clients. There were no obstructions. There were no bodies of water observed anywhere on the property. Garage: Garage was organized and free of obstructions. Emergency Phone Numbers, and Exit Plan: Let-Us-KNOW poster and clients rights are posted. General items: LPA's observed a working facility phone. LPA's reviewed COMPONENT III with the applicant during this Pre Licensing Inspection. This facility physical plant is prepared for licensure at this time. A copy of this report was discussed and provided to Lariza Holcomb Ramos-Administrator at the conclusion of the visit.the state’s words, verbatim · CDSS document, Sep 9, 2024