Angels Care Guest Home at Malinda

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Michael Tea conducted an unannounced visit to the facility to complete the Annual Required Inspection. LPA Tea was greeted and granted entry by facility staff, and the purpose of the visit was explained. Licensee (LE) Ruby Cruz arrived shortly thereafter to assist with the inspection. The facility is licensed for a capacity of six non-ambulatory residents, including one bedridden resident, and has a hospice waiver for six residents. At the time of the visit, there were six residents in care, one resident is currently receiving hospice services. LPA Tea reviewed six resident files and two staff files. All files contained the required documentation. The Administrator Certificate is current and expires on March 25, 2028. Accompanied by care staff, LPA Tea toured the facility, including the physical plant, checked food service areas, and first aid supplies. The facility consists of five resident bedrooms, two bathrooms, a living room, family room, kitchen, dining area, and an attached garage. Smoke detectors and carbon monoxide detectors were observed in common areas and bedrooms and were operational. Resident bedrooms were appropriately furnished and contained adequate linens, closet space, and drawer space to meet residents' needs. Bathrooms were clean and in good repair. Toilets and faucets were operational, grab bars were securely installed, and showers were free of mold and mildew. Water temperature measured approximately 120°F. LPA informed the licensee that the water temperature was high and should be lowered to ensure resident safety. An adequate supply of towels, toiletries, and personal hygiene items was observed. (Annual Inspection report continued on LIC809C) Common areas were clean, organized, and free of hazards. Pathways and exits were unobstructed. The first aid kit was fully stocked with the required supplies, including bandages, dressings, tweezers, scissors, and a thermometer. The kitchen was inspected and found to contain an adequate supply of perishable and nonperishable food. Appliances were operational at the time of the visit. Sharps were secured in a locked kitchen drawer. Toxic substances were locked and inaccessible to residents, including those stored beneath the kitchen sink and in the garage. The fire extinguisher located in the family room was fully charged. The most recent disaster drill was conducted on April 20, 2026. Emergency food and water supplies were adequately stocked and stored in the garage. Outdoor areas were also inspected. The backyard provided ample shaded seating for residents. The side exit gate was self-latching and operating properly. The facility provides activities tailored to residents' interests, abilities, and health conditions. Activities include morning exercises, dancing, and walks. At the time of the visit, residents were observed watching television and socializing in the family room. LPA reviewed medication storage and administration practices. Medications were stored in a locked closet and were being administered in accordance with physician orders. LPA interviewed residents regarding their quality of care and spoke with staff regarding services provided. Based on observations made during today's inspection, no deficiencies were cited in the areas reviewed in accordance with Title 22, Division 6 of the California Code of Regulations. An exit interview was conducted with Licensee Ruby Cruz. A copy of this report LIC809, along with LIC809-C, LIC858, and LIC859, was reviewed and provided to the facility.the state’s words, verbatim · CDSS document, Jun 12, 2026

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Sean Haddad conducted this announced inspection for the purpose of conducting a pre-licensing inspection. LPA met with Applicant (AP) Janice Jabonero, discussed the purpose of the inspection, and toured the facility. Facility is to operate a Residential Care Facility for the Elderly. Application was submitted to Community Care Licensing on November 20, 2024. This is a change of ownership with persons in care. During the inspection, LPA and AP observed the following: Structure: facility is a five-bedroom, two-bathroom, one-story house with an attached garage that is being used for storage. Facility telephone number is (657) 251-0692. Resident Bedrooms: the five resident bedrooms are spacious and will easily accommodate the residents’ furnishings. Lights, chairs, linens, and storage for each resident bedroom inspected. Staff Bedrooms: there are no staff bedrooms. Bathrooms: were clean, faucets and toilets were operational. Water temperature: tested between 112 and 118 degrees F in the two bathrooms. Linens & Hygiene Supplies: new linens and fully stocked linen closets were observed. Emergency Phone Numbers, Exit Plan & Menu: reviewed. Food Service: two days perishable and seven days nonperishable food supply reviewed. 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 garage. Medication cabinet is locked. First-Aid Kit & Activity Supplies: observed and available. Resident & Staff Files: LPA reviewed two resident files and two staff files. Fire clearance was approved by the City of Garden Grove Fire Department on January 22, 2025, for five non-ambulatory and one bedridden. Backyard exit gate is operational and unlocked. Backyard has shaded area for outdoor activities and sufficient seating for residents. Component III was completed with AP during today’s inspection. Facility is currently operating under the liability insurance of current facility ANGELS CARE GUEST HOME (306005476). AP will switch liability insurance to new facility once the application is approved. During the inspection, LPA explained the process of this application and about the post licensing inspection once the facility is licensed. AP was informed today that the facility is ready for licensure and final approval will be processed by the CAB supervisor in Sacramento. An exit interview was conducted and a copy of this report was discussed with and provided to AP.the state’s words, verbatim · CDSS document, May 1, 2025

Type of visit: Office

Facility Type: RCFE Application Type: INITIAL Capacity: 6 Census (if any clients in care): COMP II Participants: RUBYLYN CRUZ AND JANICE JABONDERO-APPLICANT AND ADMINISTRATOR Interview Method: Telephone interview On 4/1/25, applicant/administrator participated in COMP II. Identification of the applicant and administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant and administrator confirmed that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Admission Policies 3. Staffing requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, Apr 3, 2025