VILLA ANGELA RESIDENTIAL HOME

Official classification

Type B

Official code

87211(a)(1)(D)

Regulation authority

CCR

What the official deficiency says

87211 - Reporting Requirements (a) Each licensee shall furnish...reports as the Department may require, including, but not limited to... (1) A written report... to the licensing agency...within seven days of the occurrence of any of the events specified in (A) through (D) below. (D)Any incident which threatens the welfare, safety or health of any resident... This has not been met as evidenced by: LPA's record reviews revealed Administrator did not submit any LIC624 on 04/23/26, which poses/posed a potential health risk to residents in care.

Official plan of correction

LPA and Administrator have agreed that the facility will train care staff regarding reporting requirements, under 87211. Facility will require all staff who have conducted in-service training to follow a sign-in sheet which will include the section(s) of 87211 that have been covered. Administrator will forward all information to LPA, via email, at MARIO.LEON@DSS.CA.GOV

Deadline recorded: Aug 24, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87705(5)(6)

Regulation authority

CCR

What the official deficiency says

(5) Each resident with dementia shall have an annual medical assessment as specified in Section 87458, Medical Assessment, and a reappraisal done at least annually, both of which shall include a reassessment of the resident’s dementia care needs. (6) Appraisals are conducted on an ongoing basis pursuant to Section 87463, Reappraisals. This requirement is not met as evidenced by: Deficient Practice Statement Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above. LPA identified R1-R3 with dementia and required current medical and appraisal assements. This poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 04/10/2023 Plan of Correction Licensee/Administrator will comply to Title 22 Section 87705 and ensure residents with dementia must have annual medical and appraisals for resident #1-#3. Proof of correction must be submitted to LPA by due date 04/10/23.

Official classification

Type B

Official code

87411(1)

Regulation authority

CCR

What the official deficiency says

(1) Staff providing care shall receive appropriate training in first aid from persons qualified by such agencies as the American Red Cross. This requirement is not met as evidenced by: Deficient Practice Statement Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above. LPA identified staff #5-#7 did not have current First Aid/CPR certificates on file. This poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/24/2023 Plan of Correction Licensee/Admnistrator will comply to Title 22 Section 87411 and ensure that all direct staffd working with residents in care must have valid First Aid/CPR certificate on file. Proof of correction must be submitted to LPA by due date 03/24/23.