Angels Assisted Living,inc..

Licensing Program Analyst, Bethany Mirlohi arrived on July 30, 2026 for an unannounced inspection to follow up on a substantiated complaint investigation. LPA met with Facility Representative, caregiver Edghard Zadrach and explained the purpose of today’s visit. Licensee Simran Bhatia requested to speak to LPA over the phone and have caregiver sign on reports. On October 28, 2025, the Department concluded a complaint investigation regarding the following allegations: Staff neglect resulted in a resident sustaining multiple pressure injuries and staff neglect led to the serious hospitalization of a resident, and facility did not notify responsible parties of hospitalization. On that date, the licensee was cited for three (3) citations, two (2) of those three (3) California Code of Regulations (CCR), Title 22, § 87466 Observation of the Resident and CCR, Title 22, § 87463(f) Reappraisals, are related to the allegation noted above. At the time of the complaint visit on October 28, 2025, an immediate civil penalty of $500 was issued and the licensee was informed that an additional civil penalty might be assessed based on Health and Safety Code § 1569.49. Continuation on 809-C. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 The Department has concluded an analysis and has determined that a civil penalty is warranted for serious bodily injury. The Welfare and Institutions Code Section § 15610.67 defines serious bodily injury as "an injury involving extreme physical pain, substantial risk of death, or protracted loss or impairment of a function of a bodily member, organ, or of mental faculty, or requiring medical intervention, including but not limited to, hospitalization, surgery, or physical rehabilitation.” Facility staff failed to ensure resident (R1) physical condition was cared for in a manner that met the resident’s needs leading to pressure injuries worsening to an unstageable degree, resulting in R1 requiring hospitalization. Today, July 30, 2026, the Department will be issuing a civil penalty per Health and Safety Code § 1569.49 for a violation that the Department constitutes as a serious bodily injury in the amount of $10,000. However, since an immediate civil penalty of $500 was previously issued on October 28, 2025, the amount of the civil penalty issued today will be $9,500. Exit interview conducted. A copy of the report issued. Appeal rights provided. Edghard Zadrach name and signature on this report acknowledges receipt of the appeal rights, found on page two of LIC 421D.

Licensing Program Analyst, Bethany Mirlohi arrived on July 30, 2026 for an unannounced inspection to follow up on substantiated allegations resulting from a complaint investigation. LPA met with caregiver Edghard Zadrach and explained the purpose of today’s visit. Administrator Simranjit Bhatia requested to speak to LPA over the phone and have caregiver sign on reports. On October 28,2025, the Department concluded a complaint investigation regarding the following allegation: Staff neglect resulted in a resident sustaining a fracture due to a fall. On that date, the licensee was cited for three (3) citations one (1) of those three (3), California Code of Regulations (CCR), Title 22, § 87468.2(a)(4) Additional Personal Rights of Residents in Privately Operated Facilities, is related to the allegation noted above. At the time of the complaint visit on October 28, 2025, the licensee was informed that a civil penalty might be assessed based on Health and Safety Code § 1569.49. Continuation on 809-C. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 At the time of the complaint visit on October 28, 2025, an immediate civil penalty of $500 was issued and the licensee was informed that an additional civil penalty might be assessed based on Health and Safety Code § 1569.49. The Department has concluded an analysis and has determined that a civil penalty is warranted for serious bodily injury. The Welfare and Institutions Code Section § 15610.67 defines serious bodily injury as "an injury involving extreme physical pain, substantial risk of death, or protracted loss or impairment of a function of a bodily member, organ, or of mental faculty, or requiring medical intervention, including but not limited to, hospitalization, surgery, or physical rehabilitation.” This is evidenced by facility staff failure to properly monitor and/or implement a care plan for resident (R1), which resulted in R1 sustaining a fall while in care leading to hospitalization for injuries resulting from the fall. Today, July 30, 2026, the Department will be issuing a civil penalty per Health and Safety Code § 1569.49 for a violation that the Department constitutes as a serious bodily injury in the amount of $10,000. Exit interview conducted. A copy of the report issued. Appeal rights provided. Edghard Zadrach n ame and signature on this report acknowledges receipt of the appeal rights, found on page two of LIC 421D.

Licensing Program Analyst (LPA) Bethany Mirlohi arrived unannounced to conduct a POC visit. LPA spoke to Administrator Simranjit Bhatia over the phone and met with care staff Edghard Zadrach. During today's visit LPA reviewed deficiencies cited on 12/16/25 and the POC's sent into CCL. LPA spoke to the administrator about reporting requirements and the forms to send into CCL. Administrator voiced understanding of the reporting requirements. POC letter was provided. Copt of report given. Exit interview conducted.

LPA reviewed R1’s LIC602 in which it states resident requires assistance with repositioning and transferring and resident has a history of skin breakdown. In addition, the LIC602 states R1 has a lack of hazard awareness and has expressions of frustration. LPA reviewed R1’s needs and service plan dated 6/5/25, in which it states R1 has behaviors of yelling out and being confused and R1 requires assistance with all ADL’s. R1 no longer lives at the facility and LPA was unable to interview R1. Due to the information gathered, LPA finds allegation to be UNSUBSTANTIATED. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove that the alleged violations occurred, and the findings are unsubstantiated. Deficiencies were found, unrelated to allegation, due to investigation. See Case management visit. Exit interview conducted. Copy of report provided.

A Noncompliance Conference (NCC) was conducted today on 12/09/2025. The meeting was held at the Sacramento North Regional Office located at 9835 Goethe Road, Suite 100 Sacramento, CA 95827. The purpose of the NCC was to discuss the Substantiated complaint of a violation. Present at today’s NCC were the Regional Manager (RM) Troy Ordonez, Licensing Program Manager (LPM) Laura Munoz, Licensing Program Analyst (LPA) Graham Gunby, LPA Lavinia Muscan, (LPA) Bethany Mirlohi, and facility licensee’s Simranjit Bhatia and Damanpreet Bhatia. Topics discussed during this meeting included: Summary of substantiated complaint findings Failure to supervise residents properly Lack of staff training and competency Failure to follow care plans and HH instructions Lack of documentation (repositioning, wound care, incident reports) Personal rights concerns Facility staffing practices Observation and monitoring of residents Restricted health conditions 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 The facility has stated they will do the following to achieve continued and substantial compliance: Licensee will develop and implement procedures for observing and documenting changes in condition. Staff will be trained on when and how to monitor residents for changes such as wounds, decline, or safety concerns. Licensee shall plan on how to ensure staff follow all care plans, treatment orders and HH instructions. Licensee shall develop and maintain clear and complete records, including wound logs, repositioning logs, and change-in-condition notes. Licensee shall establish reliable communication processes with Home Health under Section 87609(b) as well as Hospice agencies. Licensee shall train staff on regulatory requirements for observing, identifying, and reporting changes in residents’ physical and mental condition. The licensee shall ensure documentation is completed promptly and accurately. Licensee shall submit a statement stating they will not accept residents with Stage 3 or Stage 4 pressure injuries unless an exception or Hospice approval is obtained. Licensee shall submit intake procedures for all new residents. Licensee shall submit a plan on how the licensee shall ensure reporting requirements are met and incident reports are submitted timely and accurately. Licensee shall submit a statement stating they understand injections may only be administered by an appropriate medical professional. All requested documentation shall be submitted to the Department no later than January 9, 2026. No deficiencies cited. Exit interview conducted. Report provided to Licensee.

Licensee does not ensure staff dispensing medication to residents are appropriately trained. Based on interviews with staff, staff indicated they received medication training. Although the licensee could not show proof that the medication training was given, two (2) staff interviews stated that they did receive medication training upon hire and on a regular basis. Based upon the information obtained during investigation, the above allegation is unsubstantiated. A finding that the complaint is UNSUBSTANTIATED means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Licensee does not ensure facility has adequate supplies to provide care to residents. Based on department observation and interviews, it was determined that the facility has adequate supplies to provide care to residents. Two (2) staff interviews indicated that although some resident supplies are not included in the admission agreement, the facility does cover supplies to provide adequate care to residents. Four (4) resident interviews indicated that their needs were being met. Based upon the information obtained during investigation, the above allegation is unsubstantiated. A finding that the complaint is UNSUBSTANTIATED means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Exit interview conducted. Report left with Administrator.

On 05/28/25, Licensing Program Analysts (LPAs) Talwinder Bains and Lavinia Muscan arrived at the facility unannounced. LPAs met with Administrator Simranjit Bhatia and explained the purpose of the visit. LPA conducted a case management visit while doing complaint follow up visit today, complaint control#: 59-AS-20250318082622. During the complaint investigation, it was learnt that resident, R1 file was missing or having incomplete documents which were required per Title 22 Regulations as below; : missing pre-appraisal admission document : admission agreement was found to be incomplete : ID form was found to be incomplete As a result of today’s visit , LIC9102 -Technical Assistance was issued. Exit interview conducted and a copy of the report was left at the facility.

**Report continued from 9099...... Allegation- Unlawful Eviction- UNSUBSTANTIATED LPA investigated allegation "unlawful eviction" and interviewed administrator. Administrator stated resident, R1 got admitted to facility on 01/06/23 and was transferred out to hospital on 04/12/24 due to change in condition. Administrator stated that R1 was very challenging with their care needs. Administrator stated they verbally informed R1s responsible party and placement agency that new placement was needed but a written 30-day notice was not given to R1. In April 2024, R1 was sent out to the emergency department. R1 needed to be discharged and administrator contacted R1 to discuss house rules via phone if R1 willing to return but R1 declined to follow any house rules and refused to return to facility. it was learnt that R1 was willingly moved to another facility after hospital discharge. Based on gathered information, this allegation was found to be UNSUBSTANTIATED. Allegation -Do to neglect, resident sustained a pressure injury. UNSUBSTANTIATED Department conducted record review and interviews with staff and witnesses to investigate this allegation. Record review reflected that resident, R1 got admitted to facility on 01/06/23 and was transferred out to hospital on 04/12/24 due to change in condition. It was also noted that R1 was on hospice care from 01/16/23 till 02/14/24 and on home health care from 02/16/24 till their hospital visit on 04/12/24. Record review reflected that R1 has wound care treatment during their facility stay and all parties were aware about those health issues. Administrator and 2 witnesses interviews reflected that R1 was not complaint with their wound care plan, but it was not due to staff’s neglect or supervision. Based on gathered information, this allegation was found to be UNSUBSTANTIATED. A finding that the complaint allegations is UNSUBSTANTIATED means that although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. Exit meeting conducted. A copy of this report has been provided to facility.

On 5/12/2025 LPA Tryon visited the facility unannounced to conduct an annual visit. LPA met with staff. Licensee was not available at the time of the visit, but arrived about 30 minutes later. LPA toured the facility including common areas, kitchen, outside areas, bedrooms, bathrooms, storage.. Smoke detectors, carbon monoxide detector installed and functioning. Fire Extinguisher present and charged. Medications are centrally stored and locked. Medications are stored in original pharmacy containers. Centrally stored medication logs are maintained for each resident. Food supplies are adequate to meet the requirement of 2 days perishable food and 7 days non-perishable food. Bedrooms are appropriately furnished with required furniture. Bathrooms are clean and functional. There is outdoor space available in the back yard. Cleaners and other potentially hazardous items are inaccessible to residents. LPA reviewed 2 resident files and 2 staff files. Files include required information. LPA reviewed the CARE Tool with staff. LPA made several suggestions that may help things run more smoothly and we discussed several issues. At this time, facility appears to be in substantial compliance. No deficiencies cited. Exit interview conducted.

On 04/16/25, Licensing Program Analyst (LPA) Talwinder Bains arrived at the facility unannounced. LPA met with Administrator Simranjit Bhatia and explained the purpose of the visit. LPA conducted a case management visit while doing complaint follow up visit today, complaint control#: 59-AS-20250318082622. During the complaint investigation, it was found that S1 was not criminally record cleared or associated to this facility and was working at the facility for more than 5 days at day of visit. The Administrator admitted that the facility failed to request a criminal clearance association for S1. S1 was sent home immediately and administrator understand that no staff can work until they are fingerprint cleared and associated with facility. As a result of todays visit deficiency cited and immediate civil penalty was assessed. Exit interview conducted and a copy of the report, LIC809G and appeal rights was left at the facility.

On September 17, 2024, Licensing Program Analyst (LPA) DeAnna Williams-Lyons arrived unannounced to conduct a Post Licensing Inspection. LPA met with Sim Bhatia, Licensee, and informed her the reason for the visit. This Post Inspection is because the facility has 2 complaints at this time and wanted to check in on the residents and staff. The facility has been licensed for 1 year. Their total capacity 6. LPA will concentrate on the facility's medication and documentation in the files. LPA reviewed the facilities resident's files and staff files. LPA also reviewed the Medical Administration Records for the residents. Fire extinguisher was CURRENT and ready for emergency use. Smoke Alarms and carbon monoxide detectors were in good condition. First Aid was complete with scissors tweezers and thermometer and guide. Licensee has 2 employees and 2 on calls that have fingerprint cleared and a current First Aid Certificate. The Fire Clearance is for 6 NON-AMBULATORY, OF WHICH 1 MAY BE BEDRIDDEN. APPROVED HOSPICE WAIVER FOR 5. The facility serves RCFE/DEMENTIA. LPA reviewed all resident files which included Service Plans, Admission Agreements, Emergency Contact,, physician reports, and Service and assessments. Staff files included first aid certificates, Criminal Clearances, health screens and emergency contacts list. Per California code of Regulations, Title 22, no citations were issued. An exit interview was conducted and a copy of this report was given to Sim.

On April 24, 2024, Licensing Program Analyst (LPA) DeAnna Williams-Lyons arrived unannounced to conduct a Required Annual Inspection. LPA met with caregiver Camille and informed her the reason for the visit. LPA and Camille completed the infectious control plan questionnaire with no issues. LPA toured the facility inside and out. The inside of the facility was observed to be in good condition The temperature was 70 degrees F. LPA observed a table in the dining area. Plates and utensils were observed to be in place. Knives are observed to not be locked in the kitchen. Dishwasher, stove, refrigerator, and microwave all present and working. This facility has a fire clearance. The facility also has a fully charged fire extinguisher and functioning smoke alarms/carbon monoxide detector and all exit doors have sound alarms. Food storage was adequate in the facility. Hot water temperature was measured at 105 F which meets the 105 F - 120F regulations. Storage and lighting were adequate in the home. All 6 bedrooms were observed to have furniture as required by Title 22 Regulations. Bathrooms were observed to be in good repair. There's adequate linens such as sheets, blankets, etc. were observed. Cleaning supplies and toxins were found to be locked. Medications are located in the hallway closet locked . To continue see 809 -C.... 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 LPA reviewed the exterior of the facility. There are no bodies of water on the premises. The perimeter fence, side gates, and latches were in good repair. Passageways are free of obstruction and potential hazards. The facility Medication Administration Record was complete and current. LPA reviewed 3 resident files and 2 staff files. Resident's Records reviewed indicated emergency contacts, Assessments, Admission Agreements and Physician's Reports were all current and up to date. Staff records reviewed revealed current First Aid & CPR certificates, Health Screenings and Emergency Contacts were all up to date and the facility is conducting staff training as required. Per California Code of Regulations Title 22, no deficiencies were found. The administrator shall submit updated copies of the(LIC 500) Personnel Report, (LIC 308) Designation of Administrative Responsibility,(LIC 610D) the Emergency Disaster Plan, and copy of current Liability Insurance to update the facility file. Administrator shall submit the listed documents to Licensing no later than May 24, 2024. An exit interview was conducted and a copy of this report was given.