Angel Comfort Care 1

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Jessica Cho arrived at the facility unannounced for the purpose of conducting the Required 1-Year annual evaluation using the CARE Inspection Tool. LPA was greeted and granted entry by Caregiver Ricky Edora after introducing self and stating the reason for the visit. Administrator (Admin) Angelina Teves arrived on premise shortly after to assist with the inspection. Admin has a valid certificate expiring on August 26, 2026. The following was observed during the inspection: This is a two story property located in a residential neighborhood comprised of four resident bedrooms and two resident bathrooms on the first floor. There are three bedrooms and two bathrooms on the second floor occupied by the live-in staff and administrator. Facility operates within the conditions and limitations specified on the license. There are two staff on duty with six residents in care, two of which are receiving hospice services. LPA along with Admin toured the interior portion of the facility. The facility is clean and in good repair. All common areas were inspected including the garage. LPA inspected all resident bedrooms. The resident bedrooms' were appropriately furnished, beds and bedding supplies were in good condition, adequate lighting was provided, and sufficient storage space for each residents' personal belongings were observed. All resident bathrooms were found be in compliance, clean, and operational. Slip resistant mats were available. The hot water temperature in the resident bathrooms measured at 114.9 and 113.0 degrees Fahrenheit. Toxins, disinfectants, sharps, and medications were secured and inaccessible. LPA observed ample two-day supply of perishables and seven-day supply of non-perishable food. LPA toured the exterior portion of the facility. The outdoor passageway is free of obstruction. The exit gates are operational, and there are sufficient seating and shading in the patio area. The pool is inaccessible secured by a lock enclosed by a perimeter fencing. The first aid kit contains all necessary elements. The fire extinguisher on each floor were mounted, charged, and serviced on March 4, 2025, which is past due. An appointment to service the extinguishers today were scheduled during the visit. The auditory devices and smoke/carbon monoxide detectors were tested and operational on both floors. Facility maintains emergency food and water. The Complaint Poster, 'See Something, Say Something,' (PUB 475) was available and posted in the correct size in the entryway. LPA reviewed six of six resident and two personnel files in which no discrepancies were found. Medications were audited for two out of six residents. No discrepancies found with medication administration and documentation. Present staff are background cleared and associated to the facility. 40 hour initial staff training for present two of two staff are incomplete. Present two staff are not CPR/First Aid certified. Disaster drills are not conducted quarterly as last known drill per documentation was conducted on August 23, 2025. LPA consulted on the following: to ensure that the fire extinguishers are serviced annually, ensure that at least one staff are CPR/First Aid certified per shift, and to ensure staff completes their initial 40 hour and disaster drill training on a quarterly basis for each shift. Based on the observations made during today's visit, deficiencies are being cited, advisory notes are being issued. An exit interview was conducted with Administrator Angelina Teves, and a copy of this report including the appeal rights were provided at exit.the state’s words, verbatim · CDSS document, Mar 10, 2026

The state marks this report as 6 pages; the online copy we transcribed has 5. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Hanna Gough arrived at the facility to conduct the required annual inspection and was greeted and granted entry by staff. LPA informed Administrator (AD) Angelina Teves the purpose of the inspection. The facility currently has six residents. LPA observed residents lounging in the living room watching tv and relaxing in their bedrooms. The facility is a two-story home with four resident bedrooms, three staff bedrooms, one staff bathroom, two resident bathrooms, kitchen, dining room, living room, backyard, swimming pool and attached 2-car garage. Facility appears clean, safe and sanitary. All resident bedrooms had the required component and furnishings. Facility has extra clean linens for resident use in the hall closet. Restrooms are stocked with soap, toilet paper, and paper towels. Hot water in the bathrooms measured between116.7-120.2 degrees Fahrenheit in the resident bathroom located in the hall and in resident room four. LPA observed the kitchen to be clean. LPA observed that the sharps are locked in a drawer located in the kitchen and inaccessible to residents in care. LPA observed fire extinguishers in the kitchen and by the front door to be charged and have a service date of March 4, 2025. LPA observed the centrally stored medications were locked in a cabinet located in the garage and is inaccessible to residents in care. LPA observed the facility has emergency food and water supply. LPA observed that the toxins and chemicals are locked in a cabinet in the garage and under the kitchen sink making them inaccessible to residents in care. The backyard has a shaded seating area for client use and is free of debris and obstructions. The backyard has an in ground swimming pool that is fully enclosed by a wrought iron gate along with the perimeter fencing. The swimming pool gate swings away from the pool with a lock at the top. The fence is five feet five inches in height and the vertical bars are five and a half inches apart. There is one resident bathroom window that leads to the pool that does not have an alarm. Carbon monoxide detectors were found to not be operational. Continued on LIC 809-C LPA reviewed two staff files and no discrepancies were observed. All present staff were fingerprinted and associated to the facility. LPA reviewed six resident files and no discrepancies were observed. LPA observed the last fire drill conducted was on December 28, 2024. LPA reviewed six of six client medications of which one did not have a PRN prescription. Based on today's observations citations were noted per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with Administrator Angelina Teves and a copy of this report was provided along with LIC 858, LIC 859,LIC 809-D and appeal rights .the state’s words, verbatim · CDSS document, Mar 12, 2025

Type of visit: Required - 1 Year

This unannounced inspection is being conducted by Licensing Program Analyst (LPA) Sean Haddad for the purpose of conducting a Required – 1 Year Inspection. LPA met with Administrator (AD) Angelina Teves and discussed the purpose of the inspection. LPA reviewed Infection Control requirements. At about 2:30PM, LPA and AD conducted a tour of the inside and outside of the facility, common areas, resident rooms, kitchen, and garage and observed the following: Structure: facility is a 7-bedroom, 3-bathroom, two-story house with attached garage that is being used for storage. There is a back yard with a patio cover for the residents. LPA and AD observed 2 staff and 6 residents present at the facility. Resident Bedrooms: the 4 resident bedrooms are spacious and will easily accommodate the residents’ furnishings. Furniture for each resident bedroom inspected. Staff Bedrooms: LPA inspected the 3 staff bedrooms. Bathrooms: the bathrooms were clean, faucets and toilets were operational. Water temperature: tested at 114 degrees F and 113 degrees in the two resident bathrooms. Linens & Hygiene Supplies: new linens and fully stocked linen closets were observed. Emergency Phone Numbers, Exit Plan & Menu: reviewed. Food Service: LPA observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food is available as required by regulations. Carbon Monoxide, Smoke Detectors, Fire Extinguisher: observed and tested. Appliances: stove burners, microwave, washer, and dryer inspected. Knives: observed locked in the kitchen. Toxins: observed locked in the kitchen and garage. Medication cabinet: observed to be locked. First-Aid Kit and Activity Supplies: observed and available. LPA provided AD with information on how to pay licensing fees. At about 3:00PM, LPA reviewed 4 resident files and 2 staff files, interviewed 4 residents and 2 staff, inspected medications for 4 residents. Facility does not handle resident money. During the inspection, LPA and AD observed the following: S1 and S2 are not associated to the facility and have been working at the facility for over a month based on their staff files; the facility has not been conducting emergency drills quarterly; and the facility has 2 floors but does not have an evacuation chair. Based on the observations made during today’s inspection, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. See LIC809D. Immediate civil penalties are being assessed. See LIC421BG. An exit interview was conducted and a copy of this report and appeal rights was discussed with and provided to facility representative.the state’s words, verbatim · CDSS document, Mar 26, 2024

The state marks this report as 5 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.