BLOSSOM VALLEY CARE HOME, INC.

Official classification

Type A

Official code

87303(e)(2)

Regulation authority

CCR

What the official deficiency says

87303 Maintenance and Operation (e) Water supplies and plumbing fixtures shall be maintained as follows: (2)Faucets used by residents for personal care such as shaving and grooming shall deliver hot water. Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degree F (41 degree C) and not more than 120 degree F (49 degree C). This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above by not maintaining the hot water temperature of not less than 105 deg F and not more than 120 deg F. Water temperature was measured with a digital thermometer at 140 deg F to 145 deg F for 2 bathroom and kitchen, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/24/2025 Plan of Correction LIC and ADM stated that they will submit a written plan of correction to monitor the hot water temperature to ensure compliance with the regulation of 105 degree F to 120 degree F. LIC and ADM will submit written plan by the POC due date of 12/24/2025.

Official classification

Type A

Official code

87465(h)(2)

Regulation authority

CCR

What the official deficiency says

87465(h)(2) - Incidental Medical and Dental Care (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: Deficient Practice Statement Based on observation the licensee did not comply with the section cited above by not ensuring medications for 3 residents were kept in a safe locked place that is not accessible to persons other authorized personnel. LPA observed 4 bottles of medication for 3 residents (R1 to R3) that were not locked in a safe secure place, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/24/2025 Plan of Correction LIC and ADM stated that they will submit a written plan of correction to ensure that medication are kept in a safe secure place not accessible to persons other than authorized personnel or employees who are responsible for the supervision of the centrally stored medication. LIC and ADM stated the plan will be submitted to LPA by due date of 12/24/2025.

Official classification

Type B

Official code

87465(h)

Regulation authority

CCR

What the official deficiency says

(h) The following requirements shall apply to medications which are centrally stored: This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in that 2 Out of 3 resident files were observed not matched with their medications which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 12/13/2024 Plan of Correction Administrator stated to submit a plan of correction by the POC due date to ensure residents' centrally stored medication forms were well maintained, and to provide staff training for medications. Administrator agreed to submit the training log to CCL office.

Official classification

Type B

Official code

87507(g)(3)(C)(5)(A)

Regulation authority

CCR

What the official deficiency says

Admission Agreements: Any fee that charged prior to or after admission, shall be clearly specified. Facility policy concerning refunds, including the conditions under which a refund for advanced monthly fees will be returned in the event of a resident’s death, pursuant to Health and Safety Code section 1569.652. This requirement was not met as evidenced by the facility did not refund R1's partial & full refund for April & May 2022 after R1's death. A review of the Admission Agreement on is entirely different from R1's Admission Agreement. Refund Policy has conflicting and/or misleading information.

Official plan of correction

Licensee ageed and understood to submit a new Admissions Agreement with a clear refund policies that adheres to regulations and/or laws by POC date 11/21/2022.

Deadline recorded: Nov 18, 2022. A deadline is not proof that correction was completed.