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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197610655
Report Date: 07/11/2026
Date Signed: 07/11/2026 12:49:03 PM

Document Has Been Signed on 07/11/2026 12:49 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.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME:CHRISTIAN ANGELFACILITY NUMBER:
197610655
ADMINISTRATOR/
DIRECTOR:		MEGGSKAYIIRA@GMAIL.COMFACILITY TYPE:
735
ADDRESS:22323 BARBACOA DRIVETELEPHONE:
(661) 383-3822
CITY:SANTA CLARITASTATE: CAZIP CODE:
91350
CAPACITY: 4CENSUS: 0DATE:
07/11/2026
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:53 AM
MET WITH:Sherinah NabwamiTIME VISIT/
INSPECTION COMPLETED:
01:05 PM
NARRATIVE
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Licensing Program Analyst (LPA) Christian Gutierrez conducted the annual inspection using the Compliance and Regulatory Enforcement (CARE) tools. LPA met with Sherinah Nabwami and explained reason for visit. Licensee Margaret Kayira was notified by telephone.

The facility is licensed to serve four (4) ambulatory Developmentally Disabled Clients age range from 18-59. The facility currently has no clients or staff. The facility is a single-story home, located in a residential area of Santa Clarita. A tour of the single-story facility included 3 client bedrooms, 1 staff room, 2 bathrooms (bedroom #1 has private bathroom), living room, den, kitchen, dining area, attached garage, front yard and backyard.

LPA Gutierrez conducted the tour with Sherinah Nabwami and observed the following: Each client bedroom has the required furniture and bedding. Smoke detectors/carbon monoxide detectors were observed in each room and throughout the facility and are properly operating. The facility has two (2) fire extinguishers with an expiration date of 06/2024 which are kept in kitchen and garage. Administrator will replace both fire extinguishers. Cleaning supplies and toxic substances are inaccessible locked in cupboards in kitchen and laundry area. Freezers are maintained at a temperature of 0-degree F and the refrigerators at a maximum of 45 degrees F. A sufficient supply of 2 days perishable & 7 days non-perishable foods will be purchased as soon as the home obtains first client. There was no dining table for clients Administrator stated that one has already been ordered. The hot water temperature in the bathrooms were measured at 141.6 and 143.7 not between the required range of 105-120 degrees F. There are no firearms or weapons stored at the facility. The facility does not have a swimming pool or bodies of water on the premises There is a shaded seating area for the residents located in the backyard. LPA observed broken and loose tile on steps leading to backyard.

Zero (0) staff files were reviewed, and zero (0) clients files were reviewed due to the house being empty. Infectious control plan and emergency disaster plan was reviewed. Client medications will be kept locked in a kitchen cabinet.

Per California Code of Regulations, Title 22, and California Health and Safety Code, the deficiencies observed during today’s visit will be documented on LIC809-D. Exit interview was held and a copy of the report with appeal rights was given.

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Christian Gutierrez
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/11/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/11/2026
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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Document Has Been Signed on 07/11/2026 12:49 PM - It Cannot Be Edited


Created By: Christian Gutierrez On 07/11/2026 at 12:26 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: CHRISTIAN ANGEL
FACILITY NUMBER: 197610655

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/11/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
80087(a)
Building and Grounds
(a) The facility shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in broken tile leading to backyard observed and no dining table for clients which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/25/2026
Plan of Correction
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Administrator will replace tile and send LPA picture once replaced.
Administrator will send LPA receipt for table as proof of purchase by POC due date.
Type B
Section Cited
CCR
80088(e)(1)
Fixtures, Furniture, Equipment, and Supplies
(1) Hot water temperature controls shall be maintained to automatically regulate temperature of hot water delivered to plumbing fixtures used by clients to attain a hot water temperature of not less than 105 degrees F (40.5 degrees C) and not more than 120 degrees F (48.8 degrees C).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above two (2) out of two (2) bathroom had a hot water reading of B1 143.7 and B2 141.6 which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/18/2026
Plan of Correction
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Administrator will lower water tem and send LPA a picture as proof by POC due date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
David Sicairos
NAME OF LICENSING PROGRAM MANAGER:
Christian Gutierrez
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 07/11/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/11/2026


LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 07/11/2026 12:49 PM - It Cannot Be Edited


Created By: Christian Gutierrez On 07/11/2026 at 12:26 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: CHRISTIAN ANGEL
FACILITY NUMBER: 197610655

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/11/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
80020(a)
Fire Clearance
(a) All facilities shall secure and maintain a fire clearance approved by the city or county fire department, the district providing fire protection services, or the State Fire Marshal.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above two (2) out of two (2) fire extinguishers had not been replaced or inspected which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/18/2026
Plan of Correction
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Administrator shall submit proof of service from fire department or replace the fire extinguishers and provide purchase receipts to LPA by POC due date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
David Sicairos
NAME OF LICENSING PROGRAM MANAGER:
Christian Gutierrez
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 07/11/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/11/2026


LIC809 (FAS) - (06/04)
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