Angels Home Care

Type of visit: Prelicensing

On September 3, 2026, Licensing Program Analysts Arvin Villanueva (LPA), arrived at this facility to conduct the scheduled pre-licensing inspection visit. LPA met with applicant, Anas Kasaballi and Aileen Grimesey, and stated the purpose of the visit. Note that the CARE Tool could not be opened and utilized during this visit. Overview: Facility is a one-story home located in a residential neighborhood. Facility is licensed to serve up to 5 elderly residents; up to 5 may be non-ambulatory. Facility does not have clearance for bedridden, delayed egress, and secured/locked perimeter. Physical Inspection: Areas that were inspected include, but are not limited to, the resident bedrooms, bathrooms, kitchen area, dining room, other common areas and outdoor areas. Outdoor Area: Front yard was observed to be maintained and clear of debris and obstruction. No outdoor cameras were observed. No bodies of water were observed. Outdoor passageways, walkways, driveways, and ramps are free from obstructions. Fence and gate are in good repair at this time. Shut off valves were located and advisory was provided to applicants to train each staff member to know the location of each valve and know how to operate each one in case of emergency. Per review of the facility sketch, it is missing the electric shut off on the sketch. Also missing on the facility sketch is the exit door at bedroom #1. Applicant will update the facility sketch and submit to the CAB analyst for review and approval. Common areas: Living room, recreational room and dining room were observed to be clean and in good repair. Kitchen was observed to be in a sanitary condition. According to the applicant, the garage will be locked and not accessible to residents. Residents' Bedrooms: LPA inspected 3 of 3 resident bedrooms. LPA observed the bedrooms to be fully furnished with required furniture. Bedroom #3 will be single occupancy. The other bedrooms will be double occupancy. Each bedroom is equipped with smoke detector. {1} Bathroom: The facility has two bathrooms, each equipped with operational toilets, wash basins, and full baths with showers. Both bathrooms contain non-skid flooring. Linens & Hygiene Supplies: Adequate supply of linen and hygiene supplies were observed. Emergency and Exit Plan: The Emergency Disaster Plan was observed to be posted and available for review. The facility has a fire door leading to the residents’ bedrooms, equipped with an electromagnetic door holder that activates upon smoke detector activation. The fire door was tested and found operable. Two fully charged fire extinguishers were observed: one in the living room and one in the hallway on the opposite side of the fire door. The facility has three exits: the front door, the back door, and the exit located in Bedroom #1. At the exit in the living room leading to the backyard, the ramp creates an approximately 1.5-inch drop from the landing. According to CBC 1008.1.7, the floor or landing shall not be more than ½ inch lower than the threshold of the doorway. LPA provided technical assistance, recommending that the applicant install a taller ramp at this exit to ensure safe access to the backyard for non-ambulatory residents. Dangerous Items: Sharp objects, cleaning supplies, toxins, and chemicals were observed to be locked. LPA provided technical assistance advising the applicants to ensure that all chemical and toxic items are stored separately from food items. LPA advised that all gardening tools, including lawn mowers, be kept in locked storage and inaccessible to residents. Water and room temperature: Hot water temperature was taken in one of the bathrooms and measured 117 degrees Fahrenheit. Room temperature was maintained at 73 degrees Fahrenheit throughout the visit. Food Service: Dishes, cups and flatware are stored in the kitchen cupboards, inspected and in good repair. Knives, cutlery and other sharps are locked in drawer. LPA observed at least 2-day perishable and 7-day nonperishable food supply available. Smoke Detectors and carbon monoxide: Smoke detectors were observed in each bedroom, common areas and hallways. One was tested and found to be working. The smoke detector activated the fire door to close. There two carbon monoxide detectors and found to be working. {2} Appliances: Stove burners and oven are in good working condition. Refrigerator/freezer temperature were within regulatory standard. Washer and dryer are located in the hallway area. Facility has internet access and home phone for resident use. Medications, First-Aid Kit & Records: First aid kit has been inspected which has at least the following: thermometer, tweezers, scissors, antiseptic, bandages, gauze and manual. Medications will be stored in one of the kitchen cabinets. Records will be stored in a locked closet located in the living room area. Residents & Staff Files: Applicants will be handling cash resources of residents at this time. All records will be stored in a cabinet located in the living room area. Advisory provided to ensure they have Surety Bond in place. Activity Supplies/Materials: LPA observed activity supplies in the living room. Advisory was provided for applicants to provide residents with a variety of activities and choices. Large television was observed in the living room. Posters: LPA observed the following posters: Personal Rights, ‘See Something, Say Something’ and Ombudsman posters. Component III: Component III was conducted with applicant. This pre-licensing is complete and no deficiencies were observed. Applicants were advised to contact the office once they admit their first resident. An exit interview was conducted, and a copy of the report was provided. {3}the state’s words, verbatim · CDSS document, Sep 3, 2026

Type of visit: Office

Component II completion: Successful Facility Type: RCFE Application Type: INITIAL Capacity: 5 Census (if any clients in care): 0 COMP II Participants: Anas Kasaballi CEO/ Tierra Green Administrator Interview Method: Telephone interview On August 18, 2026, Applicant/Administrator participated in COMP II. Identification of the applicant and administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant and 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 the 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 Readiness 9. Pre-licensing Facility Grounds Inspection and Operational Readinessthe state’s words, verbatim · CDSS document, Aug 18, 2026