Blue Pearl Home Care II

Type of visit: Required - 1 Year

On 02/17/26, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit, and requested to meet with Administrator. LPA met with staff (S1) Jelyn Pino. Licensee/Administrator (L1) Petro Crisostomo was called and stated unavailable to attend meeting. Licensee authorized staff to sign and receive report. LPA toured facility with S1. All four residents were present upon LPA arrival. One resident left for the doctor’s appointment shortly after LPA arrival. Resident observed in common area. The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside. Staff medications were observed unlocked in staff bedroom. All residents and a sample of staff files were reviewed. Medications were checked and observed kept locked in the kitchen shelf. An adequate supply of perishable and non-perishable food was observed. Knives and sharps were observed locked in kitchen drawers. Freezer temperature was observed maintained at 0 and refrigerator maintained at 40 degrees F. Fire extinguisher was observed with a purchase date of: 03/05/25. Last fire drill completed on 01/1/26. First Aid kit observed with all required items. Cleaning solutions observed locked in laundry cabinet. A chemical bottle and staff medication bottle were observed unlocked in the garage. Residents' bedrooms were toured and observed to be adequately furnished with bed, dresser, and adequate lighting. R3 bed was observed with full bed rails up. All bathrooms are observed with securely fastened grab bars and non-skid mats. Hot water temperature was tested 117.4 degrees F. in master bathroom and 112.6 degrees F in bathroom. Outside of facility toured and observed free of debris. Side gate was self-closing and self-latching. Outdoor seating observed is available for residents. Carbon monoxide and smoke detectors were tested and observed to be operational. Residents’ MARS were reviewed, and medications were checked. Technical Support Program (TSP) assistance was offered to staff. Staff will inform Licensee and will make a decision and reach out the department regarding acceptance. A deficiency and a civil penalty is being cited, per California Code of Regulations, Title 22, Division 6, see attached Lic 421IM. Exit Interview conducted. The following documents are requested and submitted to Fresno CCL by: 02/23/26. The following updated forms were requested: Lic 308, Lic 500, Lic 610E, current liability insurance, and current Administrator Certificate. A copy of this report and appeal rights was provided to Licensee/Administrator, whose signature on this form confirms receipt of this report.the state’s words, verbatim · CDSS document, Feb 17, 2026

The state marks this report as 7 pages; the online copy we transcribed has 5. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

On 03/03/25, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit, and requested to meet with Administrator. LPA met with staff Remedios Karamihan. Licensee/Administrator (L1) Petro Crisostomo and Staff 1 (S1) Jelyn Pino was called and arrived shortly. LPA toured facility with L1 and S1. All six residents were present during the inspection. Residents were observed sitting in living room, walking around, and two residents observed sleeping in the bedroom. The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside. A sample of residents and a sample of staff files were reviewed to have all the required documents. Medications were checked and observed kept locked in kitchen shelf. Residents’ MARS were reviewed, and medications were checked. An adequate supply of perishable and non-perishable food was observed. At 1:43PM, knives and tool were observed stored unlocked in kitchen drawers. Freezer temperature was observed maintained at -4 and refrigerator maintained at 30 degrees F. Fire extinguisher was observed with a service date of: 01/29/24. First Aid kit observed with all required items. Cleaning solutions observed locked in laundry cabinet. Washer and dryer observed operational. At 1:48PM, Chemical bottles observed stored on to top of dryer in laundry room unlock. Chemical observed unlocked in garage. Residents' bedrooms were toured and observed to be adequately furnished with bed, dresser, and adequate lighting. LPA observed two hospice residents. Resident was observed laying down with full rail hospital bed. All bathrooms are observed with securely fastened grab bars and non-skid mat. Hot water temperature was tested 113.1 degrees F. in master bathroom and 118.9 degrees F in bathroom. Outside of facility toured and observed free of debris. Side gate was self-closing and self-latching. Outdoor seatings observed available for residents. Carbon monoxide and smoke detectors were tested and observed to be operational. Technical Support Program (TSP) assistance was offered to Licensee. Licensee will make a decision and reach out the department regarding acceptance. A deficiency and a civil penalty is being cited, per California Code of Regulations, Title 22, Division 6, see attached Lic 421IM. Exit Interview conducted. The following documents are requested and submitted to Fresno CCL by: 03/10/25. The following updated forms were requested: Lic 308, Lic 309, Lic 500, Lic 610E, current liability insurance, and current Administrator Certificate. A copy of this report and appeal rights was provided to Licensee/Administrator, whose signature on this form confirms receipt of this report.the state’s words, verbatim · CDSS document, Mar 3, 2025

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

On 03/14/24, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit, and requested to meet with Administrator. LPA met with staff Remedios Karamihan. Licensee/Administrator (L1) Petro Crisostomo was called and arrived shortly. LPA toured facility with L1. All five residents were present during the inspection. The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside. Medications were checked and observed kept locked in kitchen shelf. Residents’ MARS were reviewed. Sharps observed locked under kitchen counter. An adequate supply of perishable and non-perishable food was observed. Fire extinguisher was observed with a service date of: 01/29/24. Cleaning chemicals observed locked in laundry room. Washer and dryer observed operational. Chemicals and garden tools observed unlocked in garage. Residents' bedrooms were toured and observed to be adequately furnished with bed, dresser, and adequate lighting. All bathrooms are observed with securely fastened grab bars and non-skid mat. Hot water temperature was tested 114.4 degrees F. in master bathroom and 111.7 degrees F in bathroom. Outside of facility toured and observed free of debris. Side gate was self-closing and self-latching. Outdoor seatings observed available for residents. Carbon monoxide and smoke detectors were tested and observed to be operational. All residents and a sample of staff files were reviewed to have all the required documents. A deficiency is being cited on the attached 809D in accordance to California Code of Regulations, Title 22, Division 6. Exit Interview conducted. The following documents are requested and submitted to Fresno CCL by: 03/20/24. The following updated forms were requested: Lic 308, Lic 500, Lic 610E, current liability insurance, and current Administrator Certificate. A copy of this report and appeal rights was provided to Licensee/Administrator, whose signature on this form confirms receipt of this report.the state’s words, verbatim · CDSS document, Mar 14, 2024

The state marks this report as 4 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.