Senior Care Records.

Facility Evaluation Report

Angel Wings Care Home III, Antioch03/17/2026Licence 079200567

Capacity6
Census5
Date signed03/17/2026 04:29:27 PM
Name of licensing program analystDaisy Panlilio
Name of licensing program managerBennett Fong
The inspector’s account

On 03/17/26 at 3:46PM, while at the facility for another reason, LPA D Panlilio observed that an uncleared and unassociated staff (S3) was working at the facility during visit. S3 stated she has not yet applied for fingerprint clearance, is not associated to the facility and has not completed the required 80 hours staff training prior to working at the facility. LPA advised staff (ADM, S1, S2) that S3 cannot stay and must leave the facility today.

At 3:55PM, LPA spoke with administrator who confirmed S3 does not have the required fingerprint clearance, association to the facility and job training prior to start of work at the facility.

Immediate civil penalty of $1,000 assessed during visit for absence of fingerprint clearance and association for S3.

Deficiency is cited per Title 22 California Code of Regulations and listed on LIC9099D. Failure to submit proof of corrections (POC) by plan of correction due dates and/or any repeat deficiencies within a 12-month period may result in civil penalties.

Exit interview conducted. Appeal Rights and a copy of this report provided.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction