197609902-2-10-2025-31-AS-TCAS-DDRS62-20250210123512

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197609902
Report Date: 02/10/2025
Date Signed: 02/10/2025 12:41:23 PM

Document Has Been Signed on 02/10/2025 12:41 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME:	AA AMERICARE HOME CARE		FACILITY NUMBER:	197609902
ADMINISTRATOR/ DIRECTOR:	MANLANGIT, RONNEL		FACILITY TYPE:	740
ADDRESS:	27710 CHERRY CREEK DR		TELEPHONE:	(661) 360-9970
CITY:	SANTA CLARITA	STATE: CA	ZIP CODE:	91354
CAPACITY: 6		CENSUS: 6	DATE:	02/10/2025
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:45 AM
MET WITH:	Ronnel Manlangit		TIME VISIT/ INSPECTION COMPLETED:	12:45 PM

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Licensing Program Analyst (LPA) Tuesday Cabiness conducted an Annual inspection. LPA was greeted by caregiver Kay Manlangit who allowed LPA to enter. Administrator Ronnel Manlangit, was contacted and arrived shortly after. Everyone was informed the reason of the visit. The current census is (6). Facility license and sketch, rights of resident council, grievance/complaint procedures, emergency disaster plan, resident bill of rights, and personal rights visibly posted.

A physical plant tour of the facility inside and outside was conducted with the caregiver. The following common areas: living, dining, kitchen, resident bedrooms, and bathrooms, staff room were inspected to ensure the facility was in compliance with Title 22 Regulations:

Kitchen: Food service area had Licensing requirement of (7) day nonperishable, and (2) day perishable. Food was properly stored in a healthy manner. Snacks and beverages are available for clients in the facility when they want. Frozen foods are properly wrapped and stored appropriately. Food storage and preparation areas are clean and inaccessible to pests. Appliances were functional and clean. Chemicals, household supplies, and knives, locked and stored in the garage area. Appliances were functional fixtures, and in good repair. Facility has an extra freezer stocked with frozen food in the garage. Living/dining/staff room: All indoor passageways were free from obstruction; inside temperature was comfortable, with adequate lighting, and all areas were clean and appropriately furnished for resident’s comfort. Bedrooms: The facility has (5) bedrooms; with (1) room for staff. Inside temperature was comfortable. All bedrooms were properly furnished and supplied with appropriate bedding and linens. Rooms observed to have bedspread, sheets, pillowcase, mattress pad, and blankets, which were in good repair. There were sufficient linens observed and available. Bathrooms: There are (2); all were clean, with soap and towels, grab bars, and non-skid mats. Hot water measured in resident’s bathroom#1, at 107.6 degrees Fahrenheit.

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Tuesday Cabiness
LICENSING EVALUATOR SIGNATURE:	DATE: 02/10/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: AA AMERICARE HOME CARE	FACILITY NUMBER: 197609902
	VISIT DATE: 02/10/2025

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Surrounding Grounds: There were no visible hazards, and passageways were free from obstruction. There is a covered patio with appropriate seating for residents when sitting outside. Smoke alarms and carbon monoxide detectors were tested and operating properly. Fire extinguisher fully charged. First aid kit furnished fully equipped. All exit doors have alarms; all were operating.

A complete record review of staff and residents were conducted.

No citations issued, exit interview, and copy of report issued.

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Tuesday Cabiness
LICENSING EVALUATOR SIGNATURE:	DATE: 02/10/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2025

LIC809 (FAS) - (06/04)

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