Angelic Hands Assisted Living

Type of visit: Required - 1 Year

On September 15, 2026 Licensing Program Analyst (LPA) Toni Nwala conducted an unannounced visit for a required annual inspection. The LPA was greeted by Caregiver Tina Smith notified them of the purpose for the visit and was allowed to enter the facility to conduct the inspection. Facility Overview: The facility is a single- story building with 4 bedrooms, 3.5 bathrooms, a dinning room, a living room, a kitchen, a staff lounge by the kitchen, an outdoor area, and a garage. There is no gated pool and there are no firearms on the premises. Infection Control: LPA observed that hygiene and cleaning supplies were available for regular facility maintenance. The facility’s infection control plan was reviewed and found to meet department's requirements. Physical Plant: The physical plant, including floors, windows, and doors, was clean and well maintained. Fixtures and furniture were in good repair. Laundry equipment was in good working condition. Sharp and dangerous objects were securely locked in the laundry room and inaccessible to residents. The smoke detector and carbon monoxide detector were operable. The water temperature was tested within regulations measuring 106.9 F. Continued 809-C...... Care & Supervision/Administration: Adequate staff were present to supervise residents during the visit. The Administrator completed renewal classes on 7/28/26-8/5/26 and is waiting for the certificate and a CPR certification with the expiration date of March 12, 2028 Record Review and Resident/Staff Files: LPA reviewed files for 2 staff members, confirming criminal clearance, updated training, and health screening. 3 clients' files were reviewed and contained all required documentation. LPA observed first kit to be available for the residents in care. The residents and staff files were kept locked and inaccessible to unauthorized individuals. Health-Related Services/Incidental Medical Services: All residents' medications were securely locked in a cabinet and located in the hallway. LPA reviewed medications for 2 residents confirming that all medication were listed and accounted for. Disaster Preparedness: LPA reviewed the facility’s emergency and disaster plan, including documentation of the last emergency drill conducted on 05-18-2026 which met the department's requirements. All facility exits were clear of obstructions. No deficiencies were cited during the visit. An exit interview was conducted, during which this report was reviewed, and a copy was emailed to Synthia Luna and signed by caregiver Tina Smith.the state’s words, verbatim · CDSS document, Sep 15, 2026

Allegation investigated: Licensee failed to issue refund. Licensee signed resident up for hospice without consent from responsible party. Facility staff failed give resident their belongings after being discharged.

Licensing Program Analyst (LPA) Abdoulaye Zerbo conducted a subsequent complaint visit to deliver final findings for the above allegations. During today’s visit, LPA met with Tina Smith and explained the reason for the visit. Licensee Synthia Luna was contacted via telephone. It was alleged that Licensee failed to issue refund. Concerns were raised that after resident 1 (R1) left the facility, the facility staff refused to issue a refund. LPA interviewed the licensee and the information obtained revealed R1 was admitted under the Assisted Living Waiver (ALW) program. A $500 pre-admission fee was collected when moving in. according to licensee and records review, the $500 was meant to cover the Administrator’s time to complete the necessary documentation (Assessment, contact physician). Unsubstantiated The Licensee further stated that the facility held the resident’s bed for approximately two months following his departure, more than what is required in accordance with program guidelines. It was alleged that Licensee signed resident up for hospice without consent from responsible party (RP). Concerned were raised that the RP was contacted by a hospice representative requested medical records to determine eligibility for hospice. LPA conducted interview with licensee and the information obtained revealed that no hospice agencies were contacted for R1. There is no documentation or evidence indicating that hospice services were initiated or that medications were administered without proper authorization. It was alleged facility staff failed to give resident their belongings after being discharged. They alleged that the facility retained the resident’s personal belongings, including a quilt, medications, clothing, slippers, a painting, and food. The Licensee confirmed that the belongings remain at the facility and have not been discarded or withheld. The Licensee stated that multiple attempts were made by the Ombudsman to contact the RP to arrange for pickup of the items, but no response was received. The facility has maintained possession of the items in a secure location and has expressed willingness to return them at any time. Based on observations, interviews, and records review, the allegations listed above are unsubstantiated. A finding that the complaint is unsubstantiated means that although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. An exit interview was conducted, this report was reviewed via telephone with Licensee Synthia Luna and a copy was provided to Caregiver Tina Smith.the state’s words, verbatim · CDSS document, Nov 26, 2025 · control 18-AS-20250917141511

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Abdoulaye Zerbo conducted an unannounced visit for a required annual inspection. The LPA was greeted by Licensee Synthia Luna, notified them of the purpose for the visit and was allowed to enter the facility to conduct the inspection. Facility Overview: The facility is a single- story building with 4 bedrooms, 3.5 bathrooms, a dinning room, a living room, a kitchen, a staff lounge by the kitchen, an outdoor area, and a garage. There is no gated pool and there are no firearms on the premises. Infection Control: LPA observed that hygiene and cleaning supplies were available for regular facility maintenance. The facility’s infection control plan was reviewed and found to meet department's requirements. Physical Plant: The physical plant, including floors, windows, and doors, was clean and well maintained. Fixtures and furniture were in good repair. Laundry equipment was in good working condition. Sharp and dangerous objects were securely locked in the laundry room and inaccessible to residents. The smoke detector and carbon monoxide detector were operable. LPA observed fire extinguishers to be in compliance with the department's requirements and with an expiration date of 04-2026. The water temperature was tested within regulations measuring 118.5 F Continued 809-C...... Care & Supervision/Administration: Adequate staff were present to supervise residents during the visit. The Administrator holds a current administrator’s certificate with the expiration date of July 23-2026 and a CPR certification with the expiration date of March 11-2026. Record Review and Resident/Staff Files: LPA reviewed files for 2 staff members, confirming criminal clearance, updated training, and health screening. 2 clients' files were reviewed and contained all required documentation. LPA observed first kit to be available for the residents in care. The residents and staff files were kept locked and inaccessible to unauthorized individuals. Health-Related Services/Incidental Medical Services: All residents' medications were securely locked in a cabinet and located in the hallway. LPA reviewed medications for 2 residents confirming that all medication were listed and accounted for. Disaster Preparedness: LPA reviewed the facility’s emergency and disaster plan, including documentation of the last emergency drill conducted on 05-21-2025, which met the department's requirements. All facility exits were clear of obstructions. No deficiencies were cited during the visit. An exit interview was conducted, during which this report was reviewed, and a copy was provided to Licensee Synthia Luna.the state’s words, verbatim · CDSS document, Jul 25, 2025

Type of visit: Case Management - Other

This Case management– Deficiencies inspection is being conducted by Licensing Program Analyst (LPA) Abdoulaye Zerbo on 02-12-24 for the purpose of issuing citations for deficiencies observed during the investigation into Complaint Control No. 18-AS-20250210130714. LPA met with Tinisha Janell Sherley and explained purpose of the visit. During the visit, LPA observed the water temperature not measuring within regulations. It was measuring at 132.4 degree. LPA did not observe a personnel roster for review. Lastly, LPA observed a resident's file not to be available at the facility for review. Based on observations, and interviews, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. See LIC809-D. An exit interview was conducted and a copy of this report and appeal rights was discussed with and provided to facility representative, Tinisha Janell Sherleythe state’s words, verbatim · CDSS document, Feb 12, 2025

From the deficiency page — Deficiency type: Type A · Section cited: CCR 80088(e)(1) · Plan of correction due date: Feb 13, 2025

80088 Furniture, Fixtures, Equipment, and Supplies (e) Faucets used by clients for personal care such as shaving and grooming shall deliver hot water. (1) Hot water temperature controls shall be maintained to automatically regulate temperature of hot water delivered to plumbing fixtures used by clients to attain a hot water temperature of not less than 105 degrees F (40.5 degrees C) and not more than 120 degrees F (48.8 degrees C). This requirement is not met as evidenced by: Based on observation and interview, licensee did not meet this requirement evidenced by the hot water temperature measuring at 132.4 degrees, which poses an immediate health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Feb 12, 2025

Plan of correction: Licensee agreed to adjust the water temperature and record the reading for ten(10) days and send proof to LPA by POC due date

From the deficiency page — Deficiency type: Type B · Section cited: CCR 85066(b) · Plan of correction due date: Feb 19, 2025

85066 Personnel Records (b) A dated employee time schedule shall be developed at least monthly, shall be displayed conveniently for employee reference and shall contain the following information for each employee: (1) Name. (2) Job title. (3) Hours of work. (4) Days off. This requirement is not met as evidenced by: Based on observation and interview, the licensee did have a personnel roster which poses a potential health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Feb 12, 2025

Plan of correction: Licensee agreed to send proof of personnel roster by POC due date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87506(a) · Plan of correction due date: Feb 19, 2025

87506 Resident Records (a) The licensee shall ensure that a separate, complete, and current record is maintained for each resident in the facility or in a central administrative location readily available to facility staff and to licensing agency staff. This requirement is not met as evidenced by: Based on observation and interview, the licensee did have a record of one resident, which poses a potential health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Feb 12, 2025

Plan of correction: Licensee agreed to send copies of resident's current records to LPA by POC due date.

Type of visit: Required - 1 Year

On 8/21/24 Licensing Program Analyst's (LPAs) Valerie Flores, Ferrer Sabarias, and Andrei Castillo conducted an unannounced one (1) year required visit. LPA's were granted entry by caregiver, Tinisha Sherley, who was informed of the purpose of visit. At the time of the visit there were one (1) staff, and four (4) residents present. Staff present was observed to have obtained proper fingerprint clearance and associated to the facility. LPA's observed the following during today's visit: LPA's conducted a tour of the facility with staff member, Tinisha Sherley. The physical plant contained (4) four resident bedrooms and two and a half (2.5) bathrooms. The common nook area appeared to have live-in staff. Per facility sketch, facility should not attain any residents or staff to reside in that common area. LPA Flores requested the Plan of Operation for the facility to which the on-site caregiver was unable to locate. The facility has a dining room, kitchen, living room, and a gated backyard. Indoor and outdoor passageways were free of obstruction. There were no bodies of water located on the property. The facility has more than a two (2) day supply of perishable foods and seven (7) day supply of non-perishable foods. Water temperature measured at 120.4-degree Fahrenheit meeting within the required limits. Dishes and utensils were in sufficient supply and in good repair. Knives and sharp items are located in the kitchen in a locked cabinet. Resident bedrooms had the required bedding, furniture, and lighting. Disinfectants and cleaning solutions were secured in a locked cabinet in the kitchen. Centrally stored medication was located in a locked cabinet in the kitchen. The smoke and carbon monoxide detectors were tested and were observed to be operable. LPA's observed charged fire extinguishers mounted in the living room. Staff files reviewed have a criminal record clearance and valid first aid/CPR certification. Resident files included but are not limited to signed admission agreements, appraisals, and needs and service plan. Per resident files reviewed, facility maintains three (3) out of four (4) residents that are under the age of 60, exceeding the Departments limitation of acceptance of residents under the age of 60. Facility sketch, personal rights, and emergency disaster plan is posted on a wall in the hallway near the entrance. According to caregiver, Tinisha, there are no firearms or ammunition on the premises. During today's visit, deficiencies and technical violations were cited and a plan of correction was discussed. An exit interview was conducted, and a copy of this report was reviewed and provided to Caregiver, Tinisha.the state’s words, verbatim · CDSS document, Aug 21, 2024