ANTELOPE VALLEY MANOR INCORPORATED

2801 HUSTON PLACE, Lancaster CA 93536

Facility 197610075 · RESIDENTIAL CARE ELDERLY (740)

6 bedsLatest official report Oct 1, 2025Licensed

Additional info
Licensee
ANTELOPE VALLEY MANOR INCORPORATED
Administrator
ROCEL B MOLINA
Contact
ROCEL B MOLINA
License first date
Sep 15, 2020
License effective date
Sep 15, 2020
District office
WOODLAND HILLS S.RO · (818) 596-4334
Regional office
31
Clients served
935 - ELDERLY

Summary

The available records show 4 Type A and 2 Type B deficiencies for this facility.

Most recent inspection
Oct 1, 2025
Most recent deficiency
Oct 1, 2025

No later report is available, so the records do not show what happened afterward.

What Type A and Type B mean
Type A
Violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
Type B
Violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care.

Both classifications are published by California CDSS and are shown as published. SeniorLivingFacts does not rename them or add a severity level of its own.

At a glance

Counts cover the five-year public record. Typical figures are the median for the 1,564 Los Angeles County facilities licensed for 6 or fewer beds.

In the available public five-year record, CCLD published 4 reports for this facility: 4 inspections, 0 complaint investigations, and 0 licensing or administrative records.

Those records contain 4 Type A and 2 Type B deficiencies.

0 deficiencies have explicit official correction or clearance evidence in the loaded records.

Official inspections
4

About the same as most this size

1 in the last 12 months

Recorded deficiencies
6

Well above the typical 1

3 in the last 12 months

Type A deficiencies
4

Most this size have none

3 in the last 12 months

Type B deficiencies
2

Most this size have none

0 in the last 12 months

Substantiated complaints
0

Most this size also have none

0 in the last 12 months

Repeated topics
0

Last 36 months

Repeated topics

Topics cited in more than one report during the last 36 months. A repeat may show a pattern worth asking about. Each date opens its report below.

No topic repeats in the last 36 months

No deficiency topic appears in more than one report during that window. This does not establish that nothing repeated earlier in the five-year record, and it is not a statement about current conditions.

Official report history

All preserved reports from the most recent to the oldest, sortable by report type.

Inspection
Facility condition and maintenanceType A
Official classification
Type A
Official code
87303(e)(2)
Regulation authority
CCR

What the official deficiency says

Water supplies and plumbing fixtures shall be maintained as follows: (2) Faucets used by residents for personal care such as shaving and grooming shall deliver hot water. Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degree F (41 degrees C) and not more than 120 degree F (49 degrees C). This requirement is not met as evidenced by: Deficient Practice Statement Based on LPAs inspection, the licensee did not comply with the section cited above, the licensee did not comply with the section cited above. At 2:20pm, LPAs measured a hot water termperature at 155.1°F. This poses an immediate health, safety risk to persons in care.

Official plan of correction

POC Due Date: 10/03/2025 Plan of Correction Licensee/Administrator agreed to adjust a hot water temperature. Licensee/Administrator will measure a hot water temperature twice a day (8am and 8pm) for seven (7) days and submit the log to LPA on 10/08/25

Plan of correction recorded
Correction not verified in available records
View official report
Health conditions and treatmentsType A
Official classification
Type A
Official code
87608(a)(3)
Regulation authority
CCR

What the official deficiency says

Postural Supports. A written order from a physician indicating the need for postural support shall be maintained in the resident’s record. The licensing agency is authorized to require additional documentation if needed This requirement is not met as evidenced by: Deficient Practice Statement Based on LPAs observation and record review, the licensee did not comply with the section cited above, by not obtaining doctors order for 1/2 bedrails for R2, R3 and R4, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/03/2025 Plan of Correction Administrator will follow up with the doctor or family member to ensure a prescription is received and kept in the file for R1, R2 and R3. A copy of the prescription order will be submitted to LPA by POC date

Plan of correction recorded
Correction not verified in available records
View official report
Medication handling and storageType A
Official classification
Type A
Official code
87465(h)(C)(2)
Regulation authority
CCR

What the official deficiency says

Incidental Medical and Dental Care(h)The following requirements shall apply to medications which are centrally stored(C) Because...dangers related to the medication itself (2)...medicines shall be kept in a safe and locked place that is not accessible to persons other than employees… This requirement is not met as evidenced by: Deficient Practice Statement Based on LPAs observation and inspection, the licensee did not comply with the section cited above, by failling to lock norco and insulin medications stored in the small refrigerator located across from bedroom #6, which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/03/2025 Plan of Correction Administrator will place a lock on the refrigerator or purchase a box with the lock and submit proof of pictures to LPA by POC date.

Plan of correction recorded
Correction not verified in available records
View official report
Inspection
Dementia careType B
Official classification
Type B
Official code
87705(j)
Regulation authority
CCR

What the official deficiency says

(j) The licensee shall have an auditory device or other staff alert feature to monitor exits, if exiting presents a hazard to any resident. 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 four (4) auditory alarms on exit doors not functioning properly at time of visit which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/04/2024 Plan of Correction Administrator agrees to send LPA notification the auditory alarms have been added or repaired via email with a picture of each auditory alarm that identified to be missing or not functioning properly by POC due date 10/04/2024.

Plan of correction recorded
Correction not verified in available records
View official report
Incident reportingType B
Official classification
Type B
Official code
87211(a)(1)(A)
Regulation authority
CCR

What the official deficiency says

a.Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following:(1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence of any of the events specified in (A) through (D) below. This report shall include the resident's name, age, sex and date of admission; date and nature of event; attending physician's name, findings, and treatment, if any; and disposition of the case. (A) Death of any resident from any cause regardless of where the death occurred, including but not limited to a day program, a hospital, en route to or from a hospital, or visiting away from the facility. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and interview, the licensee did not comply with the section cited above in three (3) residents identified by left over medication to have been deceased. Administrator could not provide date of death and admitted to submitting death reports which posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 10/04/2024 Plan of Correction Administrator agreed to submit death reports for the three (3) residents and destroy left over medication of those three residents. Administrator will submit death report via email to LPA by POC due date 10/04/2024.

Plan of correction recorded
Correction not verified in available records
View official report
Not classified in the sourceType A
Official classification
Type A
Official code
1503.2
Regulation authority
HSC

What the official deficiency says

Every facility licensed or certified pursuant to this chapter shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8 (commencing with Section 13260) of Part 2 of Division 12. The department shall account for the presence of these detectors during inspections. 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 not having at least one (1) functional carbon monoxide detector which poses an immediate health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 09/17/2024 Plan of Correction Administrator agrees to purchase new carbon monoxide detector and send picture to LPA via email by POC due date 09/17/2024.

Plan of correction recorded
Correction not verified in available records
View official report

Source and limits

California Department of Social Services, Community Care Licensing Division. Public facility history is described by the source as a five-year window. Older records and previous-licensee history may require a regional-office request. Type 741 RCFE-CCRCs, nursing homes, and other care settings are excluded from this page.

Read the data methodology