Archangel's Residential Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Carmen Lopez conducted an unannounced required Annual Inspection. The facility's history was reviewed prior to the visit. LPA identified herself and was granted entry by caregiver Arian Ysais. LPA discussed the purpose of the visit with caregiver Ysais and licensee Charise Dela Cruz who later arrived and joined the visit. According to the facility’s license, there may be a maximum of 5 residents, all of whom may be non-ambulatory in bedrooms # 1 - 4 at any given time at the facility site. The facility is approved for 2 hospice residents. During today’s inspection, the facility’s current census is 3 residents living at the facility. There were 2 residents present at the facility site during the inspection. LPA inspected the interior and exterior of the facility and inspected each room. The facility was clean, sanitary and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, windows, toilets, and showers were in working order. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and activities. There were at least 2 days of perishable food, and at least 7 days of non-perishable food present. Cooking, dining equipment and utensils were present, and all safely stored. Toxic chemicals and poisons were inaccessible to residents. Medications were properly labeled, as required, and stored in locked area, which LPA inspected. [CONTINUED ON LIC 809-C] [CONTINUED FROM LIC 809] No pools or bodies of water on the premises. The facility fireplace was inaccessible to the residents. Per licensee Dela Cruz, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and the facility telephone were all working. Fire extinguishers were present (01) and serviced within the last 12 months. The first aid kit was complete and readily accessible. LPA spoke with staff, and reviewed staff and resident records. LPAs visit did not raise any licensing concerns. The files that LPA reviewed contained the required documents. Confidential records were stored in a locked area. Required licensing postings were observed in a visible area of the facility. There was a deficiency observed and cited during today's annual inspection that may be reviewed on the LIC809-D page of this report along with Technical Advisories. An exit interview was conducted with licensee Charise Dela Cruz, to whom a copy of this report, along with the Licensee/Appeal Rights (LIC9058 03/22), were provided at the conclusion of the visit. The signature below confirms that the documents were received. LPA was provided an updated Emergency Disaster Plan (LIC610-E), Designation of Administrative Responsibility (LIC 308), and insurance updates during the visit. LPA requested licensee Dela Cruz to submit a current Personnel Report (LIC 500), to the licensing office within 10 business days. Forms are available at www.ccld.ca.gov.the state’s words, verbatim · CDSS document, Dec 11, 2025

The state marks this report as 7 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Iby Strong conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified herself to, and discussed the purpose of the visit with Administrator Charise De La Cruz. According to the facility’s license, the facility has a maximum capacity of five (5) residents, of whom all may be non-ambulatory. LPA toured the interior and exterior of the facility and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Doors, windows, toilets, and showers were in working order. Extra linens and hygiene supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities. There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. There were no toxic chemicals/poisons accessible to residents. Medications were labeled, as required, and stored in locked areas. No pools or bodies of water on the premises. Per Administrator, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher(s) were present. First aid kit(s) were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. Resident records contained all required documents. Personnel records reviewed contained required documentation. No deficiencies were cited on todays date. An exit interview was conducted with Administrator, to whom a copy of this report, and the Licensee/Appeal Rights (LIC 9058 03/22) were provided to.the state’s words, verbatim · CDSS document, Dec 6, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Iby Strong conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified herself to, and discussed the purpose of the visit with Director Charise Candare. According to the facility’s license, the facility has a maximum capacity of five (5) residents, of whom all may be non-ambulatory. LPA toured the interior and exterior of the facility and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Doors, windows, toilets, and showers were in working order. Extra linens and hygiene supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities. There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. There were no toxic chemicals/poisons accessible to residents. Medications were labeled, as required, and stored in locked areas. No pools or bodies of water on the premises. Per Director, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher(s) were present. First aid kit(s) were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. Resident records contained all required documents. The employee files reviewed contained did not contain current First Aid Training for Staff 1 (S1) and Staff 2 (S2) A deficiency is cited per California Code of Regulations, Title 22 (refer to the attached LIC 9099-D). An exit interview was conducted with Administrator, to whom a copy of this report, LIC 9099-C, LIC 9099-D, and the Licensee/Appeal Rights (LIC 9058 03/22) were provided to Director.the state’s words, verbatim · CDSS document, Dec 18, 2023