Angeles Home Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Hannah Rodgers conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by and discussed the purpose of the visit to Staff Leota Guevara. The facility's license shows a maximum capacity of six (6) non-ambulatory residents, of whom one (1) may be bedridden in Bedrooms 1, 2, or 6. Hospice waiver for four. During today’s inspection there were four (4) residents in care. LPA with Staff Guevara toured the interior and exterior of the facility and inspected each room. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Doors, windows, screens, 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 client activities. The facility contained at least 2 days of perishable food, and at least 7 days non-perishable food, all safely stored. Cooking, dining equipment, and utensils were present. No toxic chemicals or poisons were accessible to residents. Medications were labeled, as required, and stored in locked areas. The swimming pool on the premises was fenced, locked, and inaccessible to residents. Per Staff Guevara, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all in working order. Fire extinguishers were serviced within the last 12 months. First aid kits were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. [CONTINUED ON LIC809-C] LPA reviewed facility records. Review of facility records revealed that Administrator Michelle Matamoros’s administrator certificate expired on 08/02/2025. LPA reviewed the Department’s Administrator Certification Bureau (ACB) website and verified Administrator Michelle Matamoros was not listed on the active certificate list nor on the pending renewals application list. Review of resident records revealed that Resident #1 (R1) and Resident #2 (R2) did not have the results of their communicable tuberculosis test in their files. Furthermore, review of resident records revealed that R1 and R2 did not have a reappraisal on file, and Resident #3 (R3) and Resident #4 (R4) had their last reappraisals in 2024. Confidential records were stored in locked areas. Three (3) deficiencies were cited per California Code of Regulation, Title 22. A plan of correction was jointly formulated, and an exit interview was conducted with Staff Guevara whom a copy of this report, LIC809-C, LIC809-D pages, and the Licensee/Appeal Rights (LIC9058 03/22) were provided.the state’s words, verbatim · CDSS document, Apr 8, 2026

Type of visit: Required - 1 Year

On 04/03/2025 at 11:30 AM, Licensing Program Analyst (LPA) Melody Brown made an unannounced visit to the facility. The purpose of the visit was to conduct the required comprehensive annual inspection. LPA Brown met with a staff and was granted entry to the facility. Licensee/Administrator MIchelle Matamoros was informed of the visit. LPA Brown informed Licensee/Administrator Matamoros of the purpose of the visit. At the time of the visit there were two (2) staffs present, and six (6) residents present. The facility is a six (6) bedroom, three (3) bathroom home with a kitchen/dining area, living room/activity room, laundry room and an attached garage. The facility is Residential Care Facility for the Elderly (RCFE). LPA Brown noted that the pool in the backyard was locked and with the required fenced. The facility is licensed for a capacity of six (6) non-ambulatory residents of which one (1) may be bedridden. The facility’s approved for four (4) hospice waiver. The current census is six (6) residents. LPA Brown was accompanied by Licensee/Administrator Matamoros to conduct a general overall inspection, which included, but was not limited to the following: Physical Plant: The facility is operating in the capacity approved by Community Care Licensing Division (CCLD). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature of 75 degrees Fahrenheit (F). LPA Brown inspected resident bedrooms; they are equipped with required furniture such as: mattresses, nightstands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA Brown noted that there a non-slip mat in residents' shared bathroom. LPA Brown observed sufficient furniture and lighting throughout the facility.***Continuation in LIC809C *** LPA Brown measured and observed the water temperature in the resident bathroom to be at 113.9 degrees F. The facility is equipped with operating smoke detectors. However, LPA Brown observed no carbon monoxide detector at the facility. Deficiency will be issued. Charged fire extinguishers were also observed at the facility. Posters such as personal rights, the CCLD complaint poster, Ombudsman poster, and the disaster plan were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to residents in care. There's a designated storage space for resident/staff files. There is a medicine cabinet with the resident’s medications locked. LPA Brown observed a complete first aid kit and first aid book at the facility. Moreover, LPA Brown noted that the facility has the required emergency supplies, emergency food and emergency water maintained at the facility. Food Service: More than seven (7) days’ supply of non-perishable foods and more than two (2) days’ supply of perishable food supply were observed and sufficient for the number of residents in care. Care & Supervision: The facility has an Administrator present at the facility with appropriate and enough hours to appropriately manage the facility. The facility has sufficient number of staff to provide care and supervision to the residents in care. LPA Brown noted that the facility has a staff scheduled to work at night, awake and on duty as required for facility with dementia residents. Record Review: LPA Brown noted that the facility has an updated Infection Control Plan, Emergency Disaster Plan and updated Liability Insurance. LPA Brown reviewed three (3) resident files for admission agreements, updated physician reports, pre-placement appraisals, centrally stored medication list/physician orders and needs and services plans. LPA Brown observed resident files reviewed were complete. However, LPA Brown noted that Resident #2 (R2) has a half bed rail and per records review, R2 does not have written order from R1's physician indicating the need for half bed rail for mobility. Deficiency will be issued. In addition, LPA Brown noted that Resident #3 (R3) has a bed rail that extend fhe entire length of the bed and per interview and records review, the facility does not have an approved exemption for R3's full bed rail. Deficiency will be issued. LPA Brown reviewed three (3) staff files for First Aid/CPR certification, criminal record clearance, trainings, and health screenings with tuberculosis (TB) test result. LPA Brown noted that files reviewed were complete. ***Continuation in LIC809C*** During medication audit, LPA Brown observed that staffs at the facility are assisting their residents with their self-administered medication as prescribed by their physician. No issues noted. Based on the observations made during today’s visit, deficiencies were cited per Title 22, Division 6, Chapter 8 of the California Code of Regulations (CCR). An exit interview was conducted, and this report (LIC809), LIC809D, LIC9102 and Appeal Rights were discussed and provided to Licensee/Administrator MIchelle Matamoros.the state’s words, verbatim · CDSS document, Apr 3, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Ryan Gardner made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA met with Administrator Michelle Matamoros and was granted entry to the facility. The facility is a Residential Care Facility for the Elderly (RCFE) licensed for a capacity of six (6) non-ambulatory residents, one (1) resident may be bedridden. The current census is six (6) residents. LPA was accompanied by Administrator to conduct a general overall inspection, which included, but was not limited to, the following: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to interior and exterior passageways. The facility is maintained at a comfortable temperature. LPA inspected resident bedrooms; they are equipped with required furniture such as: mattresses, nightstands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA observed sufficient furniture and lighting throughout the facility. LPA measured and observed the water temperature in the bathrooms to be at 105.2 degrees F. The facility is equipped with operating smoke detectors and carbon monoxide alarms. The postings such as the facility license, personal rights, the CCL complaint poster, and the disaster plan were posted in a common area. The cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to the residents in care. There was a designated storage space for resident files and staff files. The medications are stored in a cabinet in the kitchen inaccessible to the residents. The non-perishable and perishable food supply is sufficient for the residents in care. The pool in the backyard is gated and locked. LPA reviewed six (6) residents files for admission agreements, updated physician reports, and needs and services plans. LPA reviewed two (2) staff files for First Aid/CPR certifications, criminal record clearances, trainings, and health screenings. Based on the observations made during today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809) was discussed and provided to Administrator Michelle Matamoros.the state’s words, verbatim · CDSS document, Mar 14, 2024