ANGELS HOME CARE

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 LPA observation, the licensee did not comply with the section cited above in one (1) out of six (5) which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 09/19/2025 Plan of Correction LPA and Administrator, Oscar Lechuga (S1), have agreed that the facility will maintain the top-left burner in order to clear this deficiency. S1 will email footage of either this burner lighting via knob or have replaced this appliance, via email at MARIO.LEON@DSS.CA.GOV, on or prior to the POC due date.

Official classification

Type B

Official code

87303(c)

Regulation authority

CCR

What the official deficiency says

(c) All window screens shall be clean and maintained in good repair. This requirement is not met as evidenced by: Deficient Practice Statement Based on LPA observation, the licensee did not comply with the section cited above in two (2) out of two (2) window screens along with kitchen screen in disrepair which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 09/19/2025 Plan of Correction LPA and Administrator, Oscar Lechuga (S1), have agreed that the facility will maintain three (3) out of three (3) window screens as observed in disrepair. S1 will forward, via email at MARIO.LEON@DSS.CA.GOV, of pictures having been replaced on or prior to the POC due date.

Official classification

Type B

Official code

1569.625(b)(2)

Regulation authority

HSC

What the official deficiency says

(2) In addition to paragraph (1), training requirements shall also include an additional 20 hours annually, eight hours of which shall be dementia care training, as required by subdivision (a) of Section 1569.626, and four hours of which shall be specific to postural supports, restricted health conditions, and hospice care, as required by subdivision (a) of Section 1569.696. This training shall be administered on the job, or in a classroom setting, or both, and may include online training. 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 for four out of five staff members which poses/posed a potential health, safety or personal rights risk to persons in care. LPA did not observe 20 hours of annual training for Staff #1, #3, #4, and #5.

Official plan of correction

POC Due Date: 08/27/2024 Plan of Correction The Administrator will email a training plan that is aligned with HSC 1569.625(b)(2) to regina.cloyd@dss.ca.gov by the POC due date. The training plan overview should include the topics, anticipated hours, and months it will be delivered.

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: Based on observation, the licensee did not comply with the section cited above due to LPA observing a piece of the fence in the backyard in disrepair and missing, while touring the outside grounds, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

Licensee will repair the fence and submit photo proof to LPA Gonzalez via email to: Elvira.Gonzalez@dss.ca.gov by the POC due date.

Deadline recorded: Jul 15, 2024. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87411(f)

Regulation authority

CCR

What the official deficiency says

(f) All personnel, including the licensee and administrator, shall be in good health, and physically and mentally capable of performing assigned tasks. Good physical health shall be verified by a health screening, including a chest x-ray or an intradermal test, performed by a physician not more than six (6) months prior to or seven (7) days after employment or licensure. A report shall be made of each screening, signed by the examining physician. The report shall indicate whether the person is physically qualified to perform the duties to be assigned, and whether he/she has any health condition that would create a hazard to him/herself, other staff members or residents. A signed statement shall be obtained from each volunteer affirming that he/she is in good health. Personnel with evidence of physical illness or emotional instability that poses a significant threat to the well-being of residents shall be relieved of their duties. 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 2 out 5 staff records did not have a Tuberculosis Test, and 1 out of 5 staff records did not have a Health Screening Report, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/16/2024 Plan of Correction Licensee will email Tuberculosis Test for Staff 2 & Staff 5, and a Health Screening Report for Staff 5 to Socorro.Leandro@dss.ca.gov.

Official classification

Type B

Official code

1569.605

Regulation authority

HSC

What the official deficiency says

On and after July 1, 2015, all residential care facilities for the elderly, except those facilities that are an integral part of a continuing care retirement community, shall maintain liability insurance covering injury to residents and guests in the amount of at least one million dollars ($1,000,000) per occurrence and three million dollars ($3,000,000) in the total annual aggregate, caused by the negligent acts or omissions to act of, or neglect by, the licensee or its employees. This requirement is not met as evidenced by: Deficient Practice Statement Based on interview and record review, the licensee did not comply with the section cited above in not having liability insurance, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/16/2024 Plan of Correction Licensee will email Liability Insurance to Socorro.Leandro@dss.ca.gov.

Official classification

Type B

Official code

87303(a)

Regulation authority

CCR

What the official deficiency says

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 a washer machine in disrepair and having a garage filled with clutter (cothing, furniture, boxes, supplies, etc.), which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/16/2024 Plan of Correction Licensee will fix current washermachine or get a new operational washer machine and clean and organize their garage. Licensee will email proof of correction to Socorro.Leandro@dss.ca.gov.

Official classification

Type B

Official code

87705(c)(6)

Regulation authority

CCR

What the official deficiency says

(c) Licensees who accept and retain residents with dementia shall be responsible for ensuring the following: (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 record review, the licensee did not comply with the section cited above in 1 out 3 resident record reviews not having an updated Appraisal & Needs Service Plan, which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 01/16/2024 Plan of Correction Licensee will email an updated Appraisal & Needs Service Plan for Resident 3.