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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198204584
Report Date: 05/26/2026
Date Signed: 05/26/2026 02:54:10 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:
05/26/2026
UNANNOUNCEDTIME BEGAN:
08:44 AM
MET WITH:Shirley Danting - AdministratorTIME COMPLETED:
03:15 PM
ALLEGATION(S):
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Staff are not refunding resident for rent.
Staff did not appropriately meet the resident bathing needs.
Staff did not ensure that hot water was made available at the facility for residents in care.
Staff did not address resident's change in condition.
Staff did not respond to resident's call button.
INVESTIGATION FINDINGS:
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On 05/26/26 Licensing Program Analsyt (LPA) Mario Leon conducted an initial, 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. S1 and CDSS toured the facility.
The investigation consisted of the following:
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. Between 09:00AM and 1:30PM, CDSS interviewed three (3) out of five (5) residents (R2 through R4) and two (2) out of six (6) staff (S1-S2) and one witness (W1). Residents one is no longer residing at the facility and W1 does not answer CDSS telephone call. Residents five through six (R5-R6) were not avaialble for interview due to their resting status.

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: 05/26/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2026
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 3
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: 05/26/2026
NARRATIVE
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The investigation revealed the following:
Regarding the allegation “Staff are not refunding resident for rent”, it is being alleged that a resident paid $6700 per month yet a prorated amount has not been established. Record reviews have revealed the following: The admission agreement has a refund policy, stated as follows: "Refunds will be granted as follows: 1. With a prior thirty (30) days written notice before the date of moving out. No thirty (30) days notice, no refund.". R1 was taken to the hospital with seven (7) days remaining in the month, on an emergency basis, and was unable to provide notice. Interviews have revealed the following: 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 that the alleged violation occurred. Therefore, the above allegation has been Unsubstantiated.
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 sacral wound, marked as having a wound volume of 0.007cm^3. 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 that the alleged violation occurred. Therefore, the above allegation has been Unsubstantiated.
Regarding the allegation “Staff did not ensure that hot water was made available at the facility for residents in care.”, it is being alleged that a resident was bathed in cold water. Record reviews revealed that water temperature averaged at 113.1°F in the facility. 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 that the alleged violation occurred. Therefore, the above allegation has been Unsubstantiated.

Report continues, please see LIC9099-C.
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Mario Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 05/26/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
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: 05/26/2026
NARRATIVE
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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 that a Licensed Vocational Nurse (LVN) 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. 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 that the alleged violation occurred. Therefore, the above allegation has been Unsubstantiated.
Regarding the allegation “Staff did not respond to resident's call button.” It is being alleged that staff did not respond to a resident’s call button. CDSS observation revealed that the call button is in working condition. 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 CDSS observation 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 that the alleged violation occurred. Therefore, the above allegation has been Unsubstantiated.

There have been zero (0) deficiencies cited during today's visit.

An exit interview was held with staff one, Shirley Danting - Administrator (S1), and a copy of this report has been provided.

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Mario Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 05/26/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3