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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198204584
Report Date: 10/07/2026
Date Signed: 10/07/2026 02:09:25 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/18/2026 and conducted by Evaluator Mario Leon
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20260518091639
FACILITY NAME:VILLA ANGELA RESIDENTIAL HOMEFACILITY NUMBER:
198204584
ADMINISTRATOR:SHIRLEY DANTINGFACILITY TYPE:
740
ADDRESS:23528 FIGUEROA STREETTELEPHONE:
(310) 835-6773
CITY:CARSONSTATE: CAZIP CODE:
90745
CAPACITY:6CENSUS: 5DATE:
10/07/2026
UNANNOUNCEDTIME BEGAN:
12:55 PM
MET WITH:Shirley Danting - Licensee/AdministratorTIME COMPLETED:
02:41 PM
ALLEGATION(S):
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Staff did not appropriately meet the resident bathing needs.
Staff did not address resident's change in condition.
INVESTIGATION FINDINGS:
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On 10/07/26 Licensing Program Analsyt (LPA) Mario Leon conducted a subsequent, unannounced, complaint visit at the facility. California Department of Social Services (CDSS) was met by staff one, Shirley Danting - Administrator (S1), and the purpose of the visit was explained.
The investigation consisted of the following:
On today's date, between 1:00PM and 2:30PM, CDSS wrote this report. On 07/28/26, 08/14/26, 08/20/26 and on 09/20/26, CDSS contacted Witness one (W1) to request contact details for witness two (W2) to obtain further details regarding resident one's (R1) stay at the facility. CDSS was not provided appropriate documentation, as requested. On 07/28/26, between 11:00AM and 4:30PM, CDSS conducted further complaint review and attempted to contact R1's Nurse (W2). On 05/26/26 CDSS requested and reviewed facility documents, listed as follows: Emergency ID form (dated: 03/16/26), Medical Assessment (dated: 03/16/26), Preplacement Appraisal (dated: 03/16/26), Resident appraisal (dated: 03/16/26), Needs and Services Plan (dated: 03/16/26) and CDSS toured the facility with S1.
Report continues, please see LIC9099-C.
Unsubstantiated
Estimated Days of Completion: 90
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Mario Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 11-AS-20260518091639
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME: VILLA ANGELA RESIDENTIAL HOME
FACILITY NUMBER: 198204584
VISIT DATE: 10/07/2026
NARRATIVE
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The investigation revealed the following:
Regarding the allegation “Staff did not appropriately meet the resident bathing needs.”, it is being alleged that staff did not follow the Dr’s orders. Record reviews have revealed that R1 was admitted with a stage two wound, marked as having a wound volume of 0.007cm^3. Record reviews have indicated the following: CDSS was unable to make contact with W2 that has visited R1 most often. On 07/28/26, 08/14/26, 08/20/26 and on 09/20/26, CDSS contacted Witness one (W1) to request contact details for witness two (W2) to obtain information regarding resident one's (R1) stay at the facility. CDSS has not been provided contact information from W1, regarding R1's hospice nurse (W2), as W1 has acquired R1's home health visitation folder. S1 does not have W2's contact information on-site. Interviews revealed that Three (3) out of three (3) residents and two (2) out of two (2) staff have denied the allegation has taken place and that Calmoseptine and Vitamins A&D have been placed on any wound. Based on record reviews and interviews conducted, the preponderance of evidence standard has not been met. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated.
Regarding the allegation “Staff did not address resident's change in condition.” It is being alleged that staff have not entered into a resident’s room, resulting in a stage 3 pressure wound. Record reviews have revealed the following: a Licensed Vocational Nurse (LVN - W2) visited R1 on 03/23/26, 03/25/26, 03/31/26, 04/02/26, 04/07/26, 04/09/26, 04/14/26, 04/21/26, and 04/23/26. Physical Therapist (PT) visited R1 on 03/26/26, 03/30/26, 04/02/26, 04/06/26, 04/09/26, 04/16/26 and 04/20/26. Occupational Therapist (OT) visited R1 on 04/03/26 and 04/08/26. Record reviews have indicated the following: CDSS was unable to make contact with W2 that has visited R1 most often. On 07/28/26, 08/14/26, 08/20/26 and on 09/20/26, CDSS contacted Witness one (W1) to request contact details for witness two (W2) to obtain further information regarding resident one's (R1) stay at the facility. CDSS was unable to make contact with witness two (W2) that has visited R1 most often. Further record reviews have indicated the following: CDSS has not been provided contact information from W1, regarding R1's hospice nurse (W2), as W1 has acquired R1's home health visitation folder. S1 does not have W2's contact information on-site. Interviews revealed that Three (3) out of three (3) residents and two (2) out of two (2) staff have denied the allegation has taken place. Based on record reviews and interviews conducted, the preponderance of evidence standard has not been met. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated.
There have been zero (0) deficiencies cited during today's visit.
An exit interview was held with Shirley Danting - Administrator and a copy of this report has been provided
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Mario Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2026
LIC9099 (FAS) - (06/04)
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