Inspection Report
Complaint Investigation
Census: 109
Capacity: 120
Deficiencies: 0
May 6, 2025
Visit Reason
The visit was an unannounced complaint investigation triggered by allegations that staff does not ensure the facility is free of mold.
Findings
The investigation found conflicting information regarding mold presence; a resident reported mold in their shower, but the Licensing Program Analyst did not observe mold during the tour. The allegation was determined to be unsubstantiated due to lack of preponderance of evidence.
Complaint Details
The complaint allegation was that staff did not ensure the facility was free of mold. The allegation was found to be unsubstantiated after investigation.
Report Facts
Complaint Control Number: 59
Capacity: 120
Census: 109
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Talwinder Bains | Licensing Program Analyst | Conducted the complaint investigation and authored the report |
| Jessica Brass | Business Office Director | Met with the Licensing Program Analyst during the investigation |
Inspection Report
Complaint Investigation
Census: 105
Capacity: 120
Deficiencies: 0
Apr 22, 2025
Visit Reason
The inspection was an unannounced complaint investigation visit conducted in response to a complaint received on 2025-03-17 alleging that staff did not keep residents' rooms clean, sanitary, and free of clutter, and that staff did not follow residents' needs and service agreements.
Findings
The investigation found both allegations to be unsubstantiated after conducting facility observations, record reviews, and interviews with staff and residents. The facility was found to be clean, safe, and sanitary, and residents' care needs were met according to their service plans and admission agreements.
Complaint Details
The complaint investigation was unsubstantiated. Allegations included staff not keeping residents' rooms clean and not following residents' needs and service agreements. The department found no evidence to support these claims, noting that one resident who allegedly refused housekeeping services had moved out prior to the investigation.
Report Facts
Complaint Control Number: 59-AS-20250317155218
Number of allegations: 2
Resident stay dates: Resident R1 lived at the facility from 2020-08-30 to 2025-01-25
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Talwinder Bains | Licensing Program Analyst | Conducted the complaint investigation and delivered findings |
| Danielle Shanklin | Administrator | Facility administrator met with Licensing Program Analyst during investigation |
| Laura Munoz | Licensing Program Manager | Named as Licensing Program Manager on the report |
Inspection Report
Annual Inspection
Census: 94
Capacity: 120
Deficiencies: 0
Jan 28, 2025
Visit Reason
The visit was an unannounced annual inspection conducted to evaluate the health and safety conditions of the Blossom Vale Senior Living Facility and ensure compliance with regulatory requirements.
Findings
The facility was found to be clean, safe, sanitary, and in good condition with no deficiencies observed or cited. Medication administration and staff training records were reviewed and found to be compliant with regulations.
Report Facts
Residents receiving hospice care: 3
Resident files reviewed: 10
Staff files reviewed: 8
Residents medications reviewed: 2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jessica Brass | Business Office Director | Assisted Licensing Program Analyst during the inspection |
| Chrystal Perez | Resident Care Director | Assisted Licensing Program Analyst during the inspection |
| Talwinder Bains | Licensing Program Analyst | Conducted the annual inspection |
Inspection Report
Complaint Investigation
Census: 90
Capacity: 120
Deficiencies: 0
Nov 7, 2024
Visit Reason
The inspection was an unannounced complaint investigation visit conducted in response to allegations that staff did not accord dignity to residents and spoke inappropriately to residents, as well as allegations that staff did not provide adequate care and supervision to residents.
Findings
The investigation included interviews with residents and staff, records review, and facility observations. The allegations that staff did not accord dignity or spoke inappropriately to residents were found to be unfounded. The allegation that staff did not provide adequate care and supervision was found to be unsubstantiated based on evidence that staff provided care per residents' needs and service plans, maintained adequate staffing, and the facility was clean and sanitary.
Complaint Details
The complaint investigation was triggered by allegations received on 10/14/2024. The allegations included staff not providing dignity and speaking inappropriately to residents, which was found unfounded, and staff not providing adequate care and supervision, which was found unsubstantiated after interviews and observations.
Report Facts
Residents interviewed: 5
Staff interviewed: 4
Resident census: 90
Facility capacity: 120
Complaint received date: Oct 14, 2024
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Talwinder Bains | Licensing Program Analyst | Conducted complaint investigation and delivered findings |
| Jessica Brass | Business Office Director | Met with Licensing Program Analyst during investigation |
| Laura Munoz | Licensing Program Manager | Named as Licensing Program Manager overseeing investigation |
| Danielle Shanklin | Administrator | Facility Administrator mentioned in report |
Inspection Report
Complaint Investigation
Census: 98
Capacity: 120
Deficiencies: 0
Jul 31, 2024
Visit Reason
The inspection was an unannounced complaint investigation visit conducted to investigate allegations regarding the sewer system, pet policy compliance, and cleanliness and safety concerns in the laundry room.
Findings
The investigation included observations, record reviews, and interviews with residents and staff. All allegations were found to be unfounded, with no evidence supporting the claims of sewer system issues, pet policy violations, or safety hazards related to exposed electric wires.
Complaint Details
The complaint investigation was triggered by allegations that the sewer system was backed-up in the kitchen, the facility was not following pet policy for residents, and the laundry room was unclean with exposed electric wires posing safety concerns. After investigation, all allegations were found to be unfounded.
Report Facts
Residents interviewed: 4
Staff interviewed: 5
Facility capacity: 120
Facility census: 98
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Talwinder Bains | Licensing Program Analyst | Conducted the complaint investigation and delivered findings |
| Danielle Shanklin | Administrator | Facility administrator met during the investigation |
| Laura Munoz | Licensing Program Manager | Named as Licensing Program Manager on the report |
Inspection Report
Complaint Investigation
Census: 92
Capacity: 120
Deficiencies: 1
Jun 20, 2024
Visit Reason
The visit was an unannounced case management inspection to follow up on a recent AWOL incident involving resident R1 who left the facility unattended on 06/03/24.
Findings
The facility failed to provide adequate care and supervision to resident R1, resulting in R1 leaving the facility unassisted, posing an immediate health and safety risk. Deficiencies were cited per California Code of Regulations, Title 22, Division 6, Chapter 8.
Complaint Details
The visit was triggered by a complaint related to resident R1's AWOL incident on 06/03/24. The incident was substantiated as the facility staff did not provide adequate supervision.
Severity Breakdown
Type A: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Failure to ensure adequate number of direct care staff to support residents with dementia, resulting in resident R1 leaving the facility unassisted on 06/03/24. | Type A |
Report Facts
Census: 92
Total Capacity: 120
Deficiencies cited: 1
Plan of Correction Due Date: Jun 21, 2024
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Danielle Shanklin | Administrator | Met with Licensing Program Analyst during inspection and named in findings |
| Talwinder Bains | Licensing Program Analyst | Conducted the inspection and signed the report |
| Laura Munoz | Licensing Program Manager | Supervisor named in report |
Inspection Report
Original Licensing
Census: 92
Capacity: 120
Deficiencies: 0
Mar 4, 2024
Visit Reason
The inspection was conducted as a pre-licensing visit for a change in ownership (CHOW) of the Blossom Vale Senior Living Facility.
Findings
The facility met all pre-licensing requirements including proper furnishing and maintenance of resident rooms, clean and sanitary common bathrooms, adequate food supply, operational smoke and carbon monoxide detectors, functional fire extinguisher, presence of grab bars, unobstructed exits, and secure storage of toxins, medications, and sharps. The disaster drill was current and the administrator holds a valid certificate.
Report Facts
Fire Clearance Capacity: 120
Food Supply Duration: 2
Food Supply Duration: 7
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Danielle Shanklin | Administrator | Met with Licensing Program Analyst during pre-licensing visit; holds current administrator certificate. |
| Talwinder Bains | Licensing Program Analyst | Conducted the pre-licensing inspection. |
| Laura Munoz | Licensing Program Manager | Named as Licensing Program Manager on the report. |
Inspection Report
Original Licensing
Capacity: 120
Deficiencies: 0
Dec 4, 2023
Visit Reason
The visit was conducted as part of a Change of Ownership application process and involved a COMP II telephone interview to verify the applicant/administrator's understanding of California Code Title 22 Regulations and facility operation requirements.
Findings
The applicant/administrator demonstrated understanding of key regulatory areas including facility operation, admission policies, staffing requirements, restricted health conditions, general provisions, emergency preparedness, complaints and reporting, and pre-licensing readiness. Identification was verified and required documentation was obtained.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Danielle Shanklin | Administrator | Applicant/administrator who participated in COMP II and confirmed understanding of regulations. |
| Jude De La Concepcion | Licensing Program Manager | Named as Licensing Program Manager overseeing the evaluation. |
| Bethany Hunter | Licensing Program Analyst | Named as Licensing Program Analyst conducting the evaluation. |
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