Senior Care Records.

Facility Evaluation Report

Angels II, Simi Valley04/18/2024Licence 565801215

Capacity6
Census5
Date signed04/18/2024 05:11:45 PM
The inspector’s account

Licensing Program Analyst (LPA) Zabel Chochian conducted a Case Management - Deficiencies visit due to deficiencies observed during the investigation related to complaint control 29-AS-20230504133547.

Licensee/Administrator did not comply with reporting requirements when resident #1 (R1) eloped from facility on 01/17/2023.

Pursuant to Title 22 Division 6 of the CA Code of Regulations, the following deficiency were cited (refer to LIC 809-D):

Exit interview conducted. Copy of this report and appeal rights provided.

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