Routine inspection·February 17, 2022

Licensing Program Analyst (LPA) Patricia Velazquez conducted an unannounced visit to Angelic Dwelling Care Home. The purpose of today's visit was to conduct a Required 1 Year inspection. LPA Velazquez was allowed entry into the facility and met with Caregiver Ana Millare. Caregiver Gloria Oblefias was also present. LPA Velazquez observed these 2 caregivers did not appear on the Facility Personnel Report Summary. LPA proceeded to call the Community Care Licensing Division (CCLD) Orange Regional Office to verify Criminal Record Clearance for these individuals. The facility is licensed for 6 non-ambulatory residents. The facility also has an approved hospice waiver for 4 residents. There are currently 3 residents living in the facility. The facility has a written emergency disaster plan. At 1:28 PM LPA Velazquez conducted a tour of the physical plant along with Caregiver Millare. The 2 story home consists of 3 resident bedrooms with 2 bathrooms downstairs and 1 staff bedroom with 1 bathroom upstairs. LPA Velazquez asked Caregiver Millare if the facility had a signal system in accordance to Title 22 regulation and indicated the facility did not have a signal system. The 3 residents in the facility appeared well-groomed and well cared-for. The resident bedrooms had the required furnishings, bed linens, and closet/drawer space to accommodate each resident comfortably. LPA Velazquez observed bed rails on one of the resident beds. LPA was informed that resident was receiving hospice services but passed away yesterday. Resident bath towels and personal hygiene supplies were adequately stocked. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure, showers were free of mold/mildew and a non-skid surface or mat was in place. LPA Velazquez tested the hot water temperature in the resident bathrooms and the temperature measured at 105.4 degrees Fahrenheit in the first bathroom and at 106.5 degrees Fahrenheit in the second bathroom. LPA Velazquez inspected the kitchen along with Caregiver Millare. Perishable and non-perishable food supply was checked and adequately stocked at the time of the visit. The fire extinguisher was fully charged. The smoke and carbon monoxide detectors were tested and found to be operational. Toxins, sharps, and medications were locked and inaccessible to residents. First aid kit was checked and found to be in order. The facility did not have a First Aid manual and LPA Velazquez advised Caregiver Millare to obtain an updated First Aid manual. LPA Velazquez along with Caregiver Millare toured the outside grounds and no bodies of water were observed. There was shading and sufficient seating for residents. Walkways around the home were clear of hazards and the exit gate was operational. The auditory alarms were noted to be in operating condition. There were no security bars or weapons on the premises. No resident or staff files were reviewed at the time of this visit. LPA Velazquez informed Caregiver Millare to ensure a written physician's order for bed rails is present in a resident's file pursuant to Title 22 Regulation Section 87608 Postural Supports. LPA Velazquez also reviewed and provided a written copy of Title 22 Section 87303(i)(1)(A-C) Maintenance and Operation regarding Signal System requirements. Caregiver Millare acknowledged receiving a copy of said regulation. Deficiencies cited under California Code of Regulations Title 22, Division 6, Chapter 8. Civil penalties were also issued. An exit interview was conducted with Caregiver Ana Millare and a copy of this report along with the appeal rights and a copy of the LIC 9098 were provided at the time of this visit.