Facility Evaluation Report

Licensing Program Analyst (LPA) Patricia Velazquez conducted an unannounced visit to Angelic Dwelling Care Home. The purpose of today's visit was to conduct a Required 1 Year inspection. LPA Velazquez was allowed entry into the facility and met with Caregiver Ana Millare. Caregiver Gloria Oblefias was also present. LPA Velazquez observed these 2 caregivers did not appear on the Facility Personnel Report Summary. LPA proceeded to call the Community Care Licensing Division (CCLD) Orange Regional Office to verify Criminal Record Clearance for these individuals. The facility is licensed for 6 non-ambulatory residents. The facility also has an approved hospice waiver for 4 residents. There are currently 3 residents living in the facility. The facility has a written emergency disaster plan.

At 1:28 PM LPA Velazquez conducted a tour of the physical plant along with Caregiver Millare. The 2 story home consists of 3 resident bedrooms with 2 bathrooms downstairs and 1 staff bedroom with 1 bathroom upstairs. LPA Velazquez asked Caregiver Millare if the facility had a signal system in accordance to Title 22 regulation and indicated the facility did not have a signal system. The 3 residents in the facility appeared well-groomed and well cared-for. The resident bedrooms had the required furnishings, bed linens, and closet/drawer space to accommodate each resident comfortably. LPA Velazquez observed bed rails on one of the resident beds. LPA was informed that resident was receiving hospice services but passed away yesterday. Resident bath towels and personal hygiene supplies were adequately stocked. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure, showers were free of mold/mildew and a non-skid surface or mat was in place. LPA Velazquez tested the hot water temperature in the resident bathrooms and the temperature measured at 105.4 degrees Fahrenheit in the first bathroom and at 106.5 degrees Fahrenheit in the second bathroom. LPA Velazquez inspected the kitchen along with Caregiver Millare. Perishable and non-perishable food supply was checked and adequately stocked at the time of the visit. The fire extinguisher was fully charged. The smoke and carbon monoxide