Angelic Mansions

Allegation investigated: Licensee allows uncleared staff to provide care to residents

Licensing Program Analyst (LPA) Sarina Ramirez conducted an unannounced visit to the facility to conduct a complaint investigation on the above allegation. LPA met with Staff Brandy Gorden, and discussed the purpose of the visit. Regarding allegation mentioned, after reviewing the Guardian website and interviewing staff, it was determined that although Staff #1 has an active background clearance, they are not associated to the facility. Staff #1 (S1) stated they believed the association request had already been submitted. LPA reviewed Staff #1’s personnel file and observed required training documentation as well as a valid CPR certificate, which was verified through the National CPR Foundation website. Based on LPA's interviews and record review, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED An exit interview was conducted where this report LIC9099, LIC9099D, and Appeal Rights were discussed and provided to Staff Brandy Gorden at the conclusion of the visit Substantiatedthe state’s words, verbatim · CDSS document, Aug 21, 2026 · control 56-AS-20260814164109

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87411(g)(2) · Plan of correction due date: Aug 28, 2026

87411 Personnel Requirements - General (g) Prior to employment or initial presence in the facility, all employees and volunteers subject to a criminal record review shall: (2) Request a transfer of a criminal record clearance as specified in Section 87355(c)...This requirement was not met as evidenced by: Based upon record review and interviews Staff #1 (S1) was no associated to the facility through guardian which poses a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Aug 21, 2026

Plan of correction: Administrator has agreed to contract guardian to be associated to the facility and provide proof to LPA by the POC due date.

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Sarina Ramirez arrived at the facility unannounced to conduct a Case Management Visit. The purpose of the case management visit was to address deficiencies observed during a required annual inspection conducted on 6/23/26 and in response to death reports submitted to the Community Care Licensing Office on 06/03/26. LPA met with Staff Brandy Gorden and stated the purpose of the visit. On 6/23/26, during the facility’s required annual inspection, deficiencies were cited for the absence of staff training logs in personnel files. LPA has not received proof of corrections for this deficiency. The Administrator stated that the only training documentation currently signed by staff pertains to ensuring chemicals are not accessible to residents. LPA informed staff that additional training logs are required to be maintained in each staff member’s personnel file. LPA discussed the incident/death reports explaining that on 6/3/26, the Department received five (5) resident death reports from the facility. The reports indicated that Resident #1 (R1) passed on 5/2/26, Resident #2 (R2) on 5/7/26, Resident #3 (R3) on 5/10/26, Resident #4 (R4) on 5/16/26, and Resident #5 (R5) on 5/30/26. Four (4) of the five (5) incident/death reports were not reported to the Department within the required time frame. Deficiencies were cited during today’s visit in accordance with Title 22, Division 6 of the California Code of Regulations. An exit interview was conducted where this report (LIC 809) and correction plans (LIC 809D) and appeal rights were discussed and copies were provided to Staff Brandy Gorden at the conclusion of the visit.the state’s words, verbatim · CDSS document, Aug 21, 2026

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87411(c) · Plan of correction due date: Aug 28, 2026

87411 Personnel Requirements - General (c) All RCFE staff who assist residents with personal activities of daily living shall receive initial and annual training as specified in Health and Safety Code sections 1569.625 and 1569.69 This requirement was not met as evidenced by: Based on observation, interviews, and record review staff did not have training logs in their personnel folders which poses a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Aug 21, 2026

Plan of correction: Administrator/Licensee has agreed to provide training and obtain logs with signatures for all staff and provide proof to LPA by the POC due date

From the deficiency page — Deficiency type: Type B · Section cited: HSC87211(1)(A) · Plan of correction due date: Aug 28, 2026

87211 Reporting Requirements (1) A written report shall be submitted to the licensing agency...for the resident within seven days of the occurrence...(A)Death of any resident from any cause... This requirement was not met as evidenced by: Based on observation, interviews, and record review staff are not reporting incidents to the department in a timely manner which poses a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Aug 21, 2026

Plan of correction: The Licensee/Administrator will review the Reporting Requirements regulation and submit a Statement of Understanding to LPA by Plan of Correction (POC) due date.

Allegation investigated: Staff does not dispose of non-consumed leftover food after 72 hours Staff does not prevent cross contamination of raw meat Staff does not ensure food is stored, prepared and served in a safe healthful manner Staff are not trained in food handling and safety procedures Staff do not ensure medications are centrally stored in a locked and safe place that are inaccessible to unauthorized persons.

Licensing Program Analyst (LPA) Sarina Ramirez conducted an unannounced visit to deliver findings on the allegations mentioned. LPA met with Administrator Steve Rajadas and explained the purpose of the visit. Regarding Allegation #1: Interviews with three (3) staff members indicated that leftover food is not frozen or reserved for residents. The Administrator informed LPA that leftover food is not served to residents; if food is not discarded after three (3) days, it is stored and frozen for Administrator use only. Interviews with three (3) residents reflected that they have not observed food being recycled and are unaware of whether food is discarded after three (3) days. During the kitchen tour, LPA did not observe any food stored beyond three (3) days. Regarding Allegation #2: LPA interviewed three (3) staff members, all of whom reported that they take precautions to prevent cross-contamination. Staff explained that raw meats are not placed directly on counters and are instead set on foil, and separate cutting boards are used. Unsubstantiated Staff also reported that the Administrator provides thorough in house training. Interviews with three (3) residents indicated they either assume staff prevent cross contamination, have not experienced any issues, or have not observed anything raising concern regarding cross contamination practices. Regarding Allegation #3: Interviews with two (2) staff members revealed that food is stored, prepared, and served in a safe manner. LPA also interviewed three (3) residents, all of whom stated that, to their knowledge, food is stored, prepared, and served in a safe and healthful manner. Regarding Allegation #4: The Administrator reported that all staff receive in-house training on food handling procedures. Two (2) staff informed LPA that they were not required to obtain a food handler’s certificate. Interviews with three (3) residents indicated that two (2) have observed staff being trained in food handling, while one resident stated they were not aware of food handling practices. Regarding Allegation #5: During the facility tour, LPA observed that the medication room door has a digital lock, and cabinets inside the medication room are also secured. Interviews with three (3) staff members confirmed that the medication room remains locked and inaccessible to residents at all times. Two (2) residents also stated that the medication room is consistently kept locked and they have never seen it open. Based on LPA’s observations, staff and resident interviews, and relevant documentation, the allegations are determined to be Unsubstantiated. An Unsubstantiated finding means that although the allegations may be valid or could have occurred, there is insufficient evidence to support that the alleged violations did or did not happen. An exit interview was conducted with Administrator Steve Rajadas, and a copy of this report was provided at the conclusion of the visit.the state’s words, verbatim · CDSS document, Jun 23, 2026 · control 56-AS-20251202152431

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sarina Ramirez made an unannounced visit to the facility to conduct a required annual inspection. LPA met with Administrator Steve Rajadas, and discussed the purpose of the visit. The facility is a Residential Care Facility for the Elderly (RCFE) with a license capacity of (15), a current census of (7). LPA Ramirez conducted an overall inspection of the facility, which included, but was not limited to, the following: Physical Plant/Environment: Indoor and outdoor passageways are free of obstruction. The facility has no swimming pool or similar bodies of water. The facility has sufficient lighting and is maintained at a comfortable temperature. The facility has sufficient indoor and outdoor space for resident activities.The facility is equipped with operating smoke detectors/carbon monoxide alarms, laundry equipment, and telephone service. Resident’s showers, toilets, and hand washing areas were operating properly. The hot water temperature in residents bathrooms measured between 105.4 and 109.4 degrees F. Six (6) resident’s bedrooms had beds, bed linen, chairs, dresser, storage space and sufficient lighting. The facility has sufficient linens, towels, and personal hygiene items for residents. The facility has posted in a common area, Ombudsman poster, facility license, resident’s rights, CCLD complaint poster, and facility sketch Food Service: Facility kitchen and dining areas are maintained clean. The facility has sufficient non-perishable and perishable food supply for residents in care. Sharps were kept locked, however bottles of bleach were left in the residents bathroom accessible to residents, deficiency issued. Continuation on LIC – 809C: Care & Supervision: Facility has 24-hour/7days a week care staff. Facility staff have current CPR/first aid training. Medical Related Services: Resident’s medications are labeled and centrally stored in a locked room, LPA audited three (3) resident's medication at random, no issued found. Record Review: Five (5) Staff files reviewed were observed to be incomplete, S1,3,4,5 had missing required training,S4 and S5's health screening was not signed by a physician, deficiency will be issued. S3 & S5 were not associated to the facility through guardian, deficiency issued. Six (6) Resident files reviewed were observed, R6 did not have a signed Physician Report, deficiency issued. Last disaster drill was conducted on 6/19/26. Facility does not have an Infection Control Plan, repeated violation issued. Facility does not have an Emergency Disaster Plan, deficiency issued. Based on observations, interview, and record review deficiencies and technical violations were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report along with LIC 809D, LIC 9102, LIC 421IM, and appeal rights was discussed and provided to Administrator Steven Rajadas at the conclusion of the visit.the state’s words, verbatim · CDSS document, Jun 23, 2026

The state marks this report as 8 pages; the online copy we transcribed has 7. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sarina Ramirez made an unannounced visit to the facility to conduct a required annual inspection. LPA met with Administrator Steve Rajadas, and discussed the purpose of the visit. The facility is a Residential Care Facility for the Elderly (RCFE) with a license capacity of (15), a current census of (12). LPA Ramirez conducted an overall inspection of the facility, which included, but was not limited to, the following: Physical Plant/Environment: Indoor and outdoor passageways are free of obstruction. The facility has no swimming pool or similar bodies of water. The facility has sufficient lighting and is maintained at a comfortable temperature. The facility has sufficient indoor and outdoor space for resident activities The facility is equipped with operating smoke detectors/carbon monoxide alarms, laundry equipment, and telephone service. Resident’s showers, toilets, and hand washing areas were operating properly, however one (1) of the resident's shared bathroom has a sink in disrepair; deficiency issued. The hot water temperature in residents bathrooms measured between 109.1 and 113 degrees F. Six (6) resident’s bedrooms had beds, bed linen, chairs, dresser, storage space and sufficient lighting. The facility has sufficient linens, towels, and personal hygiene items for residents. The facility has posted in a common area, Ombudsman poster, facility license, resident’s rights, CCLD complaint poster, and facility sketch Food Service: Facility kitchen and dining areas are maintained clean. The facility has sufficient non-perishable and perishable food supply for residents in care. Sharps and chemicals were kept locked and inaccessible to residents in care. Continuation on LIC – 809C: Care & Supervision: Facility has 24-hour/7days a week care staff. Facility staff have current CPR/first aid training. Medical Related Services: Resident’s medications are labeled and centrally stored in a locked room, LPA audited four (4) resident's medication at random, no issued found. Record Review: Four (4) Staff files reviewed were observed to be incomplete, all staff had missing required training, S3's health screening was not signed by a physician and S4 did not have a health screening or TB result; deficiency will be issued. S1,3,& 4 were not associated to the facility through guardian, deficiency issued. Four (4) Resident files reviewed were observed to be complete. Based on observations, interview, and record review deficiencies and technical violations were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report along with LIC 809D, LIC 9102, and appeal rights was discussed and provided to Administrator Steven Rajadas at the conclusion of the visit.the state’s words, verbatim · CDSS document, Dec 10, 2025

The state marks this report as 7 pages; the online copy we transcribed has 6. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sarina Ramirez made an unannounced visit to the facility to conduct a required annual inspection. LPA met with Administrator Steve Rajadas, and discussed the purpose of the visit. The facility is a Residential Care Facility for the Elderly (RCFE) with a license capacity of (15), a current census of (14). LPA Ramirez conducted an overall inspection of the facility, which included, but was not limited to, the following: Physical Plant/Environment: Indoor and outdoor passageways are free of obstruction. The facility has no swimming pool or similar bodies of water. The facility has sufficient lighting and is maintained at a comfortable temperature. The facility has sufficient indoor and outdoor space for resident activities The facility is equipped with operating smoke detectors/carbon monoxide alarms, laundry equipment, and telephone service. Resident’s showers, toilets, and hand washing areas were operating properly. The hot water temperature in residents bathrooms measured between 106 and 110 degrees F. Eight (8) resident’s bedrooms had beds, bed linen, chairs, dresser, storage space and sufficient lighting. The facility has sufficient linens, towels, and personal hygiene items for residents. The facility has posted in a common area, Ombudsman poster, facility license, resident’s rights, CCLD complaint poster, facility sketch, and menu Food Service: Facility kitchen and dining areas are maintained clean. The facility has sufficient non-perishable and perishable food supply for residents in care. Sharps and chemicals were kept locked and inaccessible to residents in care. Continuation on LIC – 809C: Care & Supervision: Facility has 24-hour/7days a week care staff. Facility staff have current CPR/first aid training. Medical Related Services: Resident’s medications are labeled and centrally stored in a locked cabinet, LPA found inconsistencies with medication distribution. Deficiency will be issued. Record Review: Four (4) Staff files reviewed were observed to be incomplete, deficiency will be issued. Four (4) Resident files reviewed were observed to be complete. Based on observations and record review deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report along with LIC 809D, and appeal rights was discussed and provided to Administrator Steven Rajadasthe state’s words, verbatim · CDSS document, Oct 21, 2024

Type of visit: Case Management - Other

On 9/19/2024 Licensing Program Analyst Sarina Ramirez arrived at the facility to amend documents originally delivered on 07/31/24 On 07/31/2024 LPA Ramirez was at the facility to initiate a complaint investigation COMPLAINT CONTROL NUMBER: 56-AS-20240726112144 The amendment was signed by Administrator Rajada and he was provided a copy of the amended report at the conclusion of the visitthe state’s words, verbatim · CDSS document, Sep 19, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Paola Guerrero made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection LPA met with Facility Administrator Steven Rajadas and was granted entry to the facility. The facility is a Residential Care Facility for Elderly (RCFE) Licensed capacity is (15) current census (9). LPA was accompanied by Facility Administrator, 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 (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature. LPA inspected client 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 temperatures in the bathrooms to be at 105.8 degrees F The facility is equipped with operating smoke detectors and carbon monoxide alarms. Posters such as personal rights, the CCL complaint poster, and the disaster plan were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to clients in care. There was a designated storage space for client/staff files. Medications are kept inside laundry room cabinets inaccessible to clients. Overall, the facility is clean, in good repair, and operating in safe conditions for clients in care. Food Service: Non-perishable and perishable food supply is sufficient for number of clients in care. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. All staff members working in the facility have criminal record clearance through the department. Record Review: LPA reviewed five (5) resident files for admission agreements, updated physician reports, and needs and services plans. LPA also reviewed four (4) staff files for First Aid/CPR certification, criminal record clearance, trainings, and health screenings. Medications were audited at random and appeared to be dispensed appropriately by staff members. 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 Facility Administrator Steven Rajadas.the state’s words, verbatim · CDSS document, Oct 4, 2023