Facility Evaluation Report

Licensing Program Analyst, Amber Coleman, (LPA) arrived at the Blossom Grace Facility unannounced to conduct the Annual Inspection. LPA was greeted and granted entry by, Administrator, Cynthia Waywilco. LPA also met, Administrator, Rolando Waywilco. LPA was provided space to work and then accompanied on a walk through of the facility.

The facility is comprised of 5 Bedrooms, (2 Staff Rooms & 3 Resident Rooms) 3 Bathrooms, Living Room, Dining Area, Kitchen, Laundry Room, backyard and attached garage. The facility is an Adult Residential Facility (ARF) also vendorized by the Inland Regional Center, designated Level 3. Administrator reports there are two, (2) residents present and 2 residents at their day program at time of visit.

LPA was accompanied by Administrators, Rolando and Cynthia Waywilco 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). Pathways interior and exterior were clutter free and unobstructed. The facility is maintained in comfortable temperature. The facility is equipped with functional smoke detectors and carbon monoxide alarms. Extra linens, hygiene supplies, toilet paper and towels were found in a hallway closet in sufficient amounts. Administrator reports fire/disaster drills are conducted on a monthly basis. Last drill conducted September 2023.

LPA observed resident rooms, each room included a bed with required linens, sufficient storage, furniture, lighting and seating. Additionally all rooms appeared neat and orderly. LPA also observed night-lights plugged in throughout the facility. LPA observed sufficient furniture and adequate seating in the living and dining rooms. The hot water temperature tested and found within regulation. LPA observed posters for resident rights, Long Term Care Ombudsman, licensing complaint, LET-US-KNOW and Infection Control posted in common areas of the facility. Cleaning supplies, toxins, sharps, and other dangerous items were kept secure in the attached garage. The resident's medication records and medications are kept secure in a kitchen cabinet. Resident, Facility and Staff files are kept secure within a file cabinet. Please see LIC809-C