Angelic Hands Care Home

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Ruth Martinez is conducting this unannounced visit for the purpose of completing an annual required inspection. LPA arrived at the facility and was greeted and granted entry by staff. LPA explained the nature of the visit. There are five (5) residents at the facility and there is one (1) resident receiving hospice services currently. LPA accompanied by staff began the tour of the inside and outside of the facility. LPA observed required department postings throughout the facility. Facility stays within the capacity limitations. There is a minimum of one week of non-perishables foods and two days of perishables foods available. There is additional food storage in the garage. The facility is maintained at a comfortable temperature. LPA inspected that medication is centrally stored in a safe locked storage cabinet located in the dining room. LPA reviewed medication and observed medication was labeled and stored inaccessible to residents in care. LPA inspected the facility bathrooms and LPA measured the hot water temperature which measured 118.9 Fahrenheit degrees. All bathrooms observed to have a supply of soap, toilet paper and towels. Bathrooms are equipped with required safety measures such as non-skid mats and grab bars. Lighting is sufficient to ensure safety and comfort. The facility is equipped with sufficient hand hygiene, cleaning, and disinfecting supplies. LPA observed that toxic chemicals, cleaning solutions and disinfectants are stored locked underneath kitchen sink and locked storage cabinet in the garage. The facility has an available clean supply of linens. LPA inspected residents’ bedrooms which had sufficient lighting to ensure safety and comfort. All bedrooms observed to have all required components. Storage space is provided for residents in their bedroom. Smoke detectors/carbon monoxide detectors were tested and found to be operational. LPA toured the outside of the Continued on LIC809-C facility and observed outdoor passageways are free of obstructions. LPA observed there are shaded seating areas for residents’ enjoyment in the backyard of the facility. LPA observed a fire extinguisher with service date of May 15, 2025, charged and mounted in the kitchen. Fire drills are conducted every three months, LPA verified fire drill logs are kept. LPA began reviewing records. LPA reviewed three resident records. All the required documentation was present and reviewed in the residents’ files. LPA reviewed three employee records. All employees present have a criminal record clearance and are associated to the facility. LPA observed records reviewed have a current First Aid certificate. LPA as a reminder provided annual fee dues information. Based on the observations made during today’s visit, no deficiencies were noted today in the areas inspected per Title 22 Division 6 of the California Code of Regulations. This report was reviewed with the facility representative, and a copy of this report was provided to the facility.the state’s words, verbatim · CDSS document, Nov 4, 2025

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Joseph Alejandre, conducted an announced visit to the facility to conduct the pre-licensing inspection. LPA met with Applicant Leah Ann Fajardo. . An initial application to operate a Residential Care Facility for the Elderly (RCFE) was submitted to CCL on January 11, 2024. The facility is to have a capacity of 6 non-ambulatory clients. LPAs observed the following. This is change of ownership with residents in care. The facility phone number is 949-455-1677. Structure: The facility is a one story home with 4 bedrooms, 2 shared and 2 private, staff room, 2 bathrooms, living room, dining room, family room, kitchen and an attached 2 car garage. Air/Heating: Central air/heating system installed with a central panel to control entire house. Resident Bedrooms: There are 4 resident bedrooms, 2 are shared and 2 are private. The bedrooms are spacious and will easily accommodate the residents' belongings. All resident rooms had the required furnishings and linens. Medications, First-Aid Kit & Book: The first aid kit and the first aid manual are stored in the medication cabinet next to the kitchen. The first aid kit has all the required elements. Medications are stored in the medication cabinet which is kept locked. Bathrooms: Both bathrooms have working showers and toilets. All bathrooms are clean and operational. Linens & Hygiene Supplies: Adequate supply of linen stored in hall closet. Emergency Phone Numbers, Exit Plan & Menu: Posted & readily available for review. The emergency disaster plan with means of exiting and emergency phone numbers listed. Menus posted and available. Menus prepared one week prior and listed for food served for one week. Food Service: There is a 2 day supply of perishable food and a 7 day supply of non-perishable food on hand in the kitchen. LPA observed a 3 day supply of emergency food and water. Smoke Detectors/Carbon Monoxide Detectors: Smoke detectors/carbon monoxide detectors tested operational. The Fire Extinguisher in the kitchen is fully charged and mounted on the side of a cabinet. Appliances: There is a convection stove, an oven, microwave oven, refrigerator and dishwasher in the kitchen. The washer and dryer are in the garage All appliances are clean and operational. Toxins: The cleaning supplies are kept locked under the kitchen sink. The knives are kept locked under the kitchen sink. Water Temperature: Hot water was measured in both bathrooms. Hot water measured at 111.9 degrees Fahrenheit. Resident & Staff Files: Resident and Staff Records will be kept locked in the medication cabinet. Reading Material, Games, Equipment & Materials: Games and puzzles are stored in the family room. Fire clearance: Fire Clearance approved by Orange County Fire Authority Inspector Ryan Boselo on April 23, 2024. Component III: Component three was waived because the Applicant is a Licensee at another Licensed facility. Facility is ready to be licensed. Applicant was informed today that the final approval will be processed by CAB (Cental Application Bureau) in Sacramento. Exit interview was conducted and a copy of this report was left with the applicant.the state’s words, verbatim · CDSS document, Oct 24, 2024

Type of visit: Office

Facility Type: CHOW Application Type: RCFE Capacity: 6 Census (if any clients in care): 6 Interview Method: Telephone interview On 9/19/2024, applicant/administrator participated in COMP II. Identification of the applicant / administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant / administrator confirmed that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Admission Policies 3. Staffing requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, Sep 19, 2024