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Inspection visit

Incident investigation

BLESSED HOMECARE 3License 3459200621 citation on this visit
1 citation recorded

Inspector’s narrative

What the inspector wrote

On November 5, 2024, Licensing Program Analyst (LPA) Cassie Yang arrived unannounced at the facility to conduct a case management visit regarding an incident reported to the Department on November 4, 2024. LPA met with Licensee and explained the purpose of the visit. The incident occurred on November 4, 2024 when R1 wanted to speak to their family member who was currently unavailable. R1 became agitated and was walking back and forth from room to dining room. Staff then observed front door to be open at 9:38AM. S1 stated R1 was not observed in sight near the facility, S1 then contacted 911 to report missing persons. Local Law Enforcement then observed R1 to be a block away from the facility. LPA requested R1's LIC 602 for review but facility does not have the following. As a result of today's visit, please see LIC 809-D. Exit interview conducted an a copy of the report and appeal rights was provided. Due to Licensee no longer being at the facility, S1 has signed the following report, signature on this form acknowledges receipt.

Citations

5 citations recorded*CCLD

What does Type A vs Type B mean?

Type A. Serious citation. Imminent or substantial risk to children. The regulator requires corrective action immediately and may impose a civil penalty.

Type B. Lower-severity citation. Corrective action required, no imminent risk. The regulator monitors compliance on the next visit.

  • 87405(d)(3)Type B

    87405 Administrator - Qualifications and Duties (d) The administrator shall have the qualifications specified in Sections 87405(d)(1) through (7). If the licensee is also the administrator, all requirements for an administrator shall apply. (3) Ability to maintain or supervise the maintenance of financial and other records. This requirement is not met as evidenced by: Based on file review and interview, Licensee did not comply as R1's skilled nursing facility discharge paperwork was mistaken for LIC 602 which R1 has no current LIC 602 on file, which poses a potential risk for residents in care.

  • 87458(a)Type B

    87458 Medical Assessment(a) Prior to a person's acceptance as a resident, the licensee shall obtain and keep on file, documentation of a medical assessment, signed by a physician, made within the last year. The licensee shall be permitted to use the form LIC 602 (Rev. 9/89), Physician's Report, to obtain the medical assessment. This requirement is not met as evidenced by: Based on file review, Licensee did not comply as R1 did not have a LIC 602 / Medical Assessment present on file which poses a potential risk for residents in care.

  • 1569.312(e)Type A

    §1569.312 Basic services requirements Every facility required to be licensed under this chapter shall provide at least the following basic services: (e) Monitoring the activities of the residents while they are under the supervision of the facility to ensure their general health, safety, and well-being. This requirement is not met as evidenced by: Based on file review of the incident report and interview, Licensee did not comply as R1 left the facility through the front door without staff seeing which poses an immediate health and saftey risk.

  • 87555aType B

    87555 General Food Service Requirements (a) The total daily diet shall be of the quality and in the quantity necessary to meet the needs of the residents and shall meet the Recommended Dietary Allowances of the Food and Nutrition Board of the National Research Council. All food shall be selected, stored, prepared and served in a safe and healthful manner.This requirement is not met as evidenced by: Based on LPA and S1's food inspection, Licensee did not comply as there was a jar of instant coffee in the pantry with expiration date of August 31, 2024, which poses a potential risk for residents in care.

  • 87355(c)Type A

    87355 Criminal Record Clearance(c) A licensee or applicant for a license may request a transfer of a criminal record clearance from one state licensed facility to another, or from Trust Line to a state licensed facility by providing the following documents to the Department:This requirement is not met as evidenced by: Based on observation, file review and interview, the licensee did not comply with the section cited above as S1 was observed to be working but are not associated to the facility roster which poses an immediate health, safety or personal rights risk to persons in care.

FAQ · About this visit

Common questions about this visit

What happened during the November 5, 2024 inspection of BLESSED HOMECARE 3?

This was a other inspection of BLESSED HOMECARE 3 on November 5, 2024. 1 citation were issued: 1 Type A (serious).

Were any citations issued to BLESSED HOMECARE 3 on November 5, 2024?

Yes, 1 citation was issued (1 Type A, 0 Type B). The first citation was for: "87405 Administrator - Qualifications and Duties (d) The administrator shall have the qualifications specified in Section..."

What type of inspection was this?

This was a other inspection. other inspections are conducted by CCLD as part of their licensing oversight.

SourceView on CCLDView original report

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Data from CCLD public records. Last updated . If you believe any information is inaccurate, report it here.