GOLDEN ANGEL OF LA HABRA II

Official classification

Type A

Official code

87202(a)

Regulation authority

CCR

What the official deficiency says

(a) All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal. Prior to accepting or retaining any of the following types of persons, the applicant or licensee shall notify the licensing agency and obtain an appropriate fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal: This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and admission, the facility was previously cited for not following their fire clearance as a new wall had been installed in the original bedroom #3 splitting it into new bedrooms #4 and #5, and the facility is continuing to work on obtaining a new occupancy code and fire clearance but the process has not yet been completed, which poses an immediate safety risk to persons in care.

Official plan of correction

POC Due Date: 07/07/2026 Plan of Correction Licensee stated they will submit an update to LPA by POC due date regarding the status of the occupancy code and fire clearance requests.

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 documents, S3's health screening does not have a TB test result, which poses a potential health risk to persons in care.

Official plan of correction

POC Due Date: 08/03/2026 Plan of Correction Licensee stated they will obtain a TB test for S3 and submit proof to LPA by POC due date.

Official classification

Type B

Official code

87411(c)(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 documents, S3's first aid training expired on June 22, 2026, which poses a potential health risk to persons in care.

Official plan of correction

POC Due Date: 08/03/2026 Plan of Correction Licensee stated they will have S3 renew their first aid training and submit proof to LPA by POC due date.

Official classification

Type B

Official code

000000

Regulation authority

CCR

What the official deficiency says

This is an amended report. This citation page was created in error.

Official plan of correction

This is an amended report. This citation page was created in error.

Deadline recorded: May 15, 2026. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87211(a)(1)(B)

Regulation authority

CCR

What the official deficiency says

87211 Reporting Requirements (a) … (1) A written report shall be submitted to the licensing agency … within seven days of the occurrence of … (B) Any serious injury… This requirement was not met as evidenced by: Based on documents and admission, the licensee did not ensure R1’s medical emergency and hospitalization on August 27, 2025, was reported to licensing, which poses a potential safety risk to persons in care.

Official plan of correction

Licensee stated that they will review Section 87211 Reporting Requirements and submit a statement of understanding to LPA by POC due date.

Deadline recorded: Sep 23, 2025. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

87202(a)

Regulation authority

CCR

What the official deficiency says

(a) All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal. Prior to accepting or retaining any of the following types of persons, the applicant or licensee shall notify the licensing agency and obtain an appropriate fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal: This requirement is not met as evidenced by: Deficient Practice Statement Based on observation, the licensee is not following their fire clearance as a new wall has been installed in the recreation room creating a new bedroom #3 and a new wall has been installed in the original bedroom #3 splitting it into new bedrooms #4 and #5, which poses an immediate safety risk to persons in care. CIVIL PENALTIES ASSESSED.

Official plan of correction

POC Due Date: 07/29/2025 Plan of Correction Licensee stated they will submit a request for a new fire clearance by POC due date.

Official classification

Type B

Official code

87355(e)(3)

Regulation authority

CCR

What the official deficiency says

(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility: (3) Request a transfer of a criminal record clearance as specified in Section 87355(c) or This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and documents, the licensee did not ensure S1, S2, and S3, who LPA confirmed are background cleared, were associated to the facility, which poses a potential safety risk to persons in care.

Official plan of correction

POC Due Date: 08/25/2025 Plan of Correction Licensee stated they will associate these staff and submit proof to LPA by POC due date.