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Inspection visit

Follow-up

ANGEL CARE HOMELicense 0792011345 citations on this visit
5 citations recorded

Inspector’s narrative

What the inspector wrote

On 11/21/2024 at 4:35pm, Licensing Program Analyst (LPA) L. Hall arrived unannounced to conduct a Case Management visit. LPA met with Ding Wang, Administrator, and explained the reason for the visit. While LPA L. Hall was conducting a complaint investigation 15-AS-20241120130942 on 11/21/2024. During tour of facility LPA observed the following deficiencies. LPA observed, a reverse door knob on room # 5 was locked and R1 was inside. LPA observed room #6 door was locked, when open LPA observed (S4) male sitting on the bed in room LPA observed during record review R1 did not have an admission agreement, consent for medical treatment, and emergency contact and identification. LPA observed during record review facility did not report hospitalization for R1. LPA observed during review of R1's medication that three (3) medication was missing. *An immediate civil penalty of $250.00 will be assessed on today's date for a repeat violation and $200.00 for fingerprint. A total of $450.00. Continued on LIC809C. Continued from LIC809. Deficiency is cited per Title 22 California Code of Regulations and listed on LIC9099D. Failure to submit proof of corrections (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted. A copy of the appeal rights, LIC421FC, LIC421BG, and this report.

Citations

5 citations recorded*CCLD

What does Type A vs Type B mean?

Type A. Serious citation. Imminent or substantial risk to children. The regulator requires corrective action immediately and may impose a civil penalty.

Type B. Lower-severity citation. Corrective action required, no imminent risk. The regulator monitors compliance on the next visit.

  • 87211(a)(1)Type B

    (a) Each licensee shall furnish to the licensing agency such reports as the Department may require...(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 requirement was not met as evidence by: Based on record review and interview the Licensee did not comply with the section cited above in report R1's hospitalization, which poses a potential health and safety risk to persons in care.

  • 87355(d)Type A

    (d) All individuals subject to criminal record review shall be fingerprinted and sign a Criminal Record Statement (LIC 508 [Rev. 1/03]) under penalty of perjury. This requirement was not met as evidence by: Based on record review and interview the Licensee did not comply with the section cited above in have a S4 residing in facility with a clearance, which poses an immediate health and safety risk to persons in care.

  • 87465(d)Type B

    (d) If the resident is unable to determine his/her own need for a prescription or nonprescription... and is unable to communicate... facility staff ... shall be permitted to assist the resident with self-administration provided all of the following requirements are met: This requirement was not met as evidence by: Based on observation the Licensee did not comply with the section cited above in having 3 prescribed medications available for R1 for administration which poses a potential health and safety risk to persons in care.

  • 87468.1(a)(6)Type B

    (a) Residents... shall have all of the following personal rights: (6) To... not be locked into any room... by day or night. This does not prohibit a licensee... locking doors at night to protect residents... This requirement was not met as evidence by: Based on observation the Licensee did not comply with the section cited above in R1 having a reversed door knob and being locked inside bedroom, which poses a potential health and safety risk for persons in cae.

  • 87506(b)Type B

    (b) Each resident’s record shall contain at least the following information: Based on LPA record review the licensee did not comply with the section cited above in having R1's file completed, which poses a potential health and safety risk for persons in care.

FAQ · About this visit

Common questions about this visit

What happened during the November 21, 2024 inspection of ANGEL CARE HOME?

This was a other inspection of ANGEL CARE HOME on November 21, 2024. 5 citations were issued: 1 Type A (serious) and 4 Type B.

Were any citations issued to ANGEL CARE HOME on November 21, 2024?

Yes, 5 citations were issued (1 Type A, 4 Type B). The first citation was for: "(a) Each licensee shall furnish to the licensing agency such reports as the Department may require...(1) A written repor..."

What type of inspection was this?

This was a other inspection. other inspections are conducted by CCLD as part of their licensing oversight.

SourceView on CCLDView original report

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Data from CCLD public records. Last updated . If you believe any information is inaccurate, report it here.