ANGELS CARE HOME

Official classification

Type A

Official code

87309(a)

Regulation authority

CCR

What the official deficiency says

(a) Except as specified in subsection (b), the licensee shall ensure that disinfectants, cleaning solutions, poisonous substances, knives, matches, tools, sharp objects, and other similar items which could pose a danger to residents are in locked storage and are not left unattended if outside the locked storage. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above in having both outdoor sheds locked which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/08/2026 Plan of Correction Licensee agreed to lock both sheds and submit photo to CCLD by POC date.

Official classification

Type B

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

(a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee did not comply with the section cited above in having the refrigerator sanitary which poses a potential health or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/14/2026 Plan of Correction Licensee agreed to clean refrigerator and submit photo to CCLD by POC date.

Official classification

Type B

Official code

1569.618(c)

Regulation authority

HSC

What the official deficiency says

(c)The facility shall employ, and the administrator shall schedule, a sufficient number of staff members to do all of the following: This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, interview, and record review, the licensee did not comply with the section cited above in having a qualified administrator employed which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/14/2026 Plan of Correction Licensee agreed to hire a qualified administrator and submit all documentation to CCLD by POC date.

Official classification

Type B

Official code

87555(b)(27)

Regulation authority

CCR

What the official deficiency says

(b) The following food service requirements shall apply: (27) All kitchen areas shall be kept clean and free of litter, rodents, vermin and insects. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, interview, and record review, the licensee did not comply with the section cited above in having the kitchen area free of insects which poses a potential health risk to persons in care.

Official plan of correction

POC Due Date: 01/14/2026 Plan of Correction Licensee agreed to contact exterminator to come more often and/or place traps or spray for insects and submit invoice to CCLD by POC date.

Official classification

Type B

Official code

87608(a)(5)(A)

Regulation authority

CCR

What the official deficiency says

(A) A bed rail that extends from the head half the length of the bed and used only for assistance with mobility shall be allowed. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, interview, and record review, the licensee did not comply with the section cited above in having a doctor's order for R1's bedrails which poses a potential safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/14/2026 Plan of Correction Licensee agreed to obtain a doctor's order for R1's bedrails and submit order to CCLD by POC date.

Official classification

Type A

Official code

87705(d)

Regulation authority

CCR

What the official deficiency says

(d) The licensee shall ensure that the facility has an auditory device or other staff alert feature to monitor exits on exterior doors and perimeter fence gates accessible to those residents who may be at risk for elopement.. This requirement is not met as evidenced by: Based on interview and record review the licensee did not comply with the section cited above by not having an auditory device or other staff alert feature to monitor all exits on exterior doors, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

Administrator agreed to purchase an auditory device for front door and send CCLD an email photo by POC date.

Deadline recorded: Oct 8, 2025. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

1569.626(a)

Regulation authority

HSC

What the official deficiency says

§1569.626 Advertising for special care, special programming, or a special environment for elderly with dementia; training requirement (b) Eight hours of in-service training per year on the subject of serving residents with dementia. This training shall be developed in consultation with individuals or organizations with specific expertise in dementia care or by an outside source with expertise in dementia care. In formulating and providing this training, reference may be made to written materials and literature on dementia and the care and treatment of persons with dementia. This training requirement may be satisfied in one day or over a period of time.......... 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 not having two (2) out of three (3) staff members documented eight hours of in-service training per year on the subject of serving residents with dementia which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/09/2025 Plan of Correction Administrator agreed to have staff complete the required hours of training and send a self certifying email to CCLD by POC date.

Official classification

Type B

Official code

1569.618(b)(3)

Regulation authority

HSC

What the official deficiency says

(b) At least one administrator, facility manager, or designated substitute who is at least 21 years of age and has qualifications adequate to be responsible and accountable for the management and administration of the facility pursuant to Title 22 of the California Code of Regulations shall be on the premises 24 hours per day. The designated substitute maybe a direct care staff member who shall not be required to meet the educational, certification, or training requirements of an administrator. The designated substitute shall meet qualifications that include, but are not limited to, all of the following: (3) Training to effectively interact with emergency personnel in the event of an emergency call, including an ability to provide a resident’s medical records to emergency responders. This requirement is not met as evidenced by: Deficient Practice Statement Based on interview & record review, the licensee did not comply with the section cited above there is no current certified Administrator working at the facility, current administrator has expired certificate on 12/15/2019 and back up administrator S2 has also expired administrator certificate on 12/1/2021 which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 02/01/2022 Plan of Correction Licensee Maria Niduaza needs to identify a certified Administrator to oversee the proper business business operation, licensee needs to submit proof of employment at CCL office by POC date.