197610652-6-8-2026-31-AS-HRAI-DUUPM4-20260608112545

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197610652
Report Date: 06/08/2026
Date Signed: 06/08/2026 11:26:20 AM

Document Has Been Signed on 06/08/2026 11:26 AM - 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.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME:	CHRISTIAN ANGEL		FACILITY NUMBER:	197610652
ADMINISTRATOR/ DIRECTOR:	KAYIIRA, MARGARET N		FACILITY TYPE:	735
ADDRESS:	3931 SADDLE DRIVE		TELEPHONE:	(661) 383-3822
CITY:	PALMDALE	STATE: CA	ZIP CODE:	93551
CAPACITY: 4		CENSUS: 0	DATE:	06/08/2026
TYPE OF VISIT:	Office	ANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	10:15 AM
MET WITH:	Margaret N Kayiira, Administrator		TIME VISIT/ INSPECTION COMPLETED:	11:30 AM

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Licensing Program Managers (LPMs) Nichelle Gillyard and Naira Margaryan and Licensing Program Analyst (LPA) Huma Rahimi met with the Administrator to conduct an Informal Conference held at the Woodland Hills South Adult and Senior Care Regional Office. The purpose of the informal conference was to discuss recent deficiencies, the Administrator's qualifications and responsibilities, and concerns regarding residents care and supervision.

LPM made introductions and verified the current Administrator information, facility telephone number, and email address.

The facility was licensed on 01/30/2025 and currently has one (1) resident in placement. LPMs and LPA reviewed the facility's staffing plan and discussed the Administrator's responsibility to ensure adequate care and supervision is provided to residents at all times.

On 05/04/2026, the Department received Complaint Control #31-AS-20260504153935. On 05/12/2026, LPAs conducted a complaint investigation and substantiated the allegation that the facility was not sufficiently staffed to meet the needs of residents in care. During the investigation, LPAs observed Resident #1 (R1) alone in the facility without staff supervision. Interviews conducted during the investigation confirmed that R1 was left alone during daytime and nighttime hours. The Administrator confirmed that no staff had been hired because the facility was awaiting vendorization through the North Los Angeles County Regional Center (NLACRC).

Continue on LIC 809C

NAME OF LICENSING PROGRAM MANAGER: Nichelle Gillyard
NAME OF LICENSING PROGRAM ANALYST: Huma Rahimi
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/08/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/08/2026

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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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.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: CHRISTIAN ANGEL	FACILITY NUMBER: 197610652
	VISIT DATE: 06/08/2026

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The following deficiencies were issued:

1. Personnel Requirements – Section 80065(a)

2. Plan of Operation – Section 80022(j)

Due to noncompliance and failure to submit Plan of Corrections. on 05/26/2026, LPA Rahimi conducted a Plan of Correction (POC) follow-up visit regarding the deficiencies cited on 05/12/2026. During the visit, LPAs again observed Resident #1 (R1) alone in the facility without care and supervision. Although the Administrator's agreed-upon corrective actions plan included relocating R1 and refraining from admitting residents until the facility became vendored by the North Los Angeles County Regional Center (NLACRC), the facility continued to operate out of scope of the approved program plan which identifies that Licensee will admit and provide care to the residents with developmental disabilities. At the time of the follow-up visit, the previously cited deficiencies remained unclear.

As a result of the continued noncompliance, facility was recited for the previous deficiencies issued during complaint investigation and under the CCR Section 80078(a) Responsibility for Providing Care and Supervision. An immediate civil penalty of $500.00 was issued for absence of supervision to the facility resident.

LPMs discussed concerns regarding the Administrator's qualifications and ability to operate the facility in compliance with licensing laws and regulations (CCR Section 80065 and Section 85065), including maintaining adequate staffing, ensuring resident care and supervision, implementing measurable and verifiable Plans of Correction, complying with the facility's approved Plan of Operation and maintaining good character and reputation of personal integrity.

The Administrator was advised about potential consequences of continued noncompliance, and discussed the process of possible adverse actions, including civil penalties and other administrative actions.

During this meeting the Administrator was provided an opportunity to discuss the circumstances surrounding the violations and provide additional information regarding current facility operations, staffing, resident placement status, and corrective actions taken or planned.

Continue on LIC 809C

NAME OF LICENSING PROGRAM MANAGER: Nichelle Gillyard
NAME OF LICENSING PROGRAM ANALYST: Huma Rahimi
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/08/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/08/2026

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.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: CHRISTIAN ANGEL	FACILITY NUMBER: 197610652
	VISIT DATE: 06/08/2026

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LPMs discussed the administrative process and answered questions presented by the Administrator. The Administrator was advised that the department will conduct frequent licensing visits to all facility under the same ownership to ensure compliance with title 22 regulations.

The Department is not deprived of its authority to take appropriate formal legal action under the Health and Safety Code when such action is deemed necessary by the Director.

In addition, a copy of previous licensing visit report (conducted on 06/02/26) was provided to the Administrator for manual signature.

Exit interview was conducted and a copy of this report was issued.

NAME OF LICENSING PROGRAM MANAGER: Nichelle Gillyard
NAME OF LICENSING PROGRAM ANALYST: Huma Rahimi
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/08/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/08/2026

LIC809 (FAS) - (06/04)

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