Angels Windsor House

On 08/12/2022 at 10:20 AM, Licensing Program Analyst (LPA) L. Holmes arrived unannounced to conduct annual Infection Control Inspection. LPA was greeted by one staff upon entry and explained the purpose of the visit. Administrator (ADM) Haidie Bautista was telephoned by the staff member and will be on her way; ADM arrived at 11:30 AM. Facility has a COVID-19 mitigation plan on file. LPA obtained a staff and resident roster. LPA observed a screening station at the entry that contained thermometer, hand sanitizer, masks, gloves, COVID-19 signage, and a visitor sign-in log. LPA toured the facility including, but not limited to common areas, bathrooms, bedrooms, kitchen, storage, garage and backyard. LPA observed mask, cough etiquette, social distancing and some hand washing signs posted throughout. ADM to post 20 seconds handwashing signs to shared bathrooms. There was a sufficient supply of 2-day perishables and 7-day supply of non-perishable foods. All hand washing stations were equipped with soap, paper towels and covered garbage cans. There is a surplus of PPE centrally located inside the facility that is accessible to all care staff. Hot water temperature in the shared residents' bathroom was measured at 105.3 degrees Fahrenheit (F) and the facility's temperature was 71 degrees (F). Fire extinguishers were observed full and last inspected on 10/11/2021. Smoke/Carbon Monoxide detectors were observed operational and first aid kit complete. The following forms are to be updated and submitted to CCLD: -LIC500 Personnel Report (Received staff roster) -LIC308 Designation of Administrative Responsibility (Reviewed) -LIC610E Emergency Disaster Plan (Reviewed) -An updated copy of Administrator Certificate(s) (Reviewed) Exit interview conducted and a copy of this report provided to ADM..

On 09/10/2025 around 02:00 PM, Licensing Program Analyst (LPA) L. Holmes arrived unannounced to conduct an annual Infection Control Inspection. LPA was greeted by one staff upon entry and explained the purpose of the visit. Haidie Bautista, Administrator (ADM) was telephoned by the staff member and gave the approval for signing the report. Facility has a COVID-19 mitigation plan, ICP & EDP on file. LPA reviewed the resident staff roster and Emergency Disaster Plan. Facility continues to screen for COVID, has hand sanitizer, COVID-19 signage, and a visitor sign-in log. LPA toured the facility including, but not limited to common areas, bathroom, kitchen, front and side pathways. LPA observed mask, cough etiquette, social distancing and hand washing signs posted throughout. There was a sufficient supply of 2-day perishables and 7-day supply of non-perishable foods. All hand washing stations were equipped with soap and covered garbage cans. ADM to add paper towels to shared bathroom. There is a surplus of PPE stored centrally located inside the facility that is accessible to all care staff. The facility's temperature was 68 degrees (F) and water in shared bathroom last measured at 109.4. Fire extinguisher was observed full and expires 11/15/24. Smoke/Carbon Monoxide detectors were observed operational and first aid kit complete. A sample of sic (6) resident and three (3) staff files were complete. The following forms are to be updated and submitted to CCLD: -LIC500 Personnel Report (Reviewed) -LIC308 Designation of Administrative Responsibility (Reviewed) -LIC610 Emergency Disaster Plan (Reviewed) -An updated copy of Administrator Certificate(s) (Reviewed) Exit interview conducted and a copy of this report provided to Nelson Juta, Staff.

Interview with W1 indicated R1 has lived at the facility for about 15 year and R1 have not expressed concerns to W1 about R1's care provided by facility staff. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did occur, therefore the allegation is UNSUBSTANTIATED . Exit interview conducted with Haidie Bautista over the phone. Administrator was not able to be at the facility and authorized house manager, Nelson Juta to sign CCLD reports. A copy of this report provided.