Arvilinh Home Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Michael Tea conducted an unannounced visit. The purpose of today’s visit was to conduct the Annual Required inspection. LPA Tea was greeted and granted entry into the facility by caregiver staff and explained the reason for the visit. Administrator (AD) Arvin Bumanglag arrived shortly to assist with the visit. Facility is licensed for six non-ambulatory residents with a hospice waiver for four. Currently there are six residents, of which three are on hospice during today's visit. LPA Tea reviewed six resident files and three staff files. There were discrepancies noted in the review of residents and staff files. Upon review of records, medical assessments need to be updated due to residents’ change of conditions and medical assessments needed to be signed by responsible party or resident. Administrator certificate expires on December 10, 2026. LPA Tea along with AD Bumanglag toured the facility. LPA toured the physical plant, checked food service, and the first aid kit. The home consists of six resident bedrooms, three bathrooms, living room, dining room, staff office area, kitchen and an attached garage. LPA observed smoke detectors/carbon monoxide in common areas and bedrooms are operational. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure and shower was free of mold/mildew. Water temperature measured between 114.0 to 114.8 Fahrenheit degrees. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked at time of visit. Common areas were clean and clear of hazards, and doorways were free of obstructions. First aid kit had all the required elements including dressing, bandages, tweezers, thermometer, and scissors. Kitchen was inspected. Annual inspection continued on LIC809-C Perishable and non-perishable food supply were checked and adequately stocked at time of visit. LPA observed sharps locked in a kitchen drawer. LPA also observed toxin substances to be secured and inaccessible to residents in the garage. Fire extinguishers throughout the facility are fully charged. The facility’s last disaster drill was conducted in February 10, 2026. Kitchen appliances are operational during today's visit. LPA toured the outside grounds and there are two exit gates on both sides of the house that are self-latching and operational. The backyard has a shaded table for clients to sit. LPA observed emergency supplies, food and water in the garage. Activities are based on resident’s personal preference or health condition. Facility provides activities like light exercises like walking outside and chair exercises. They also provide musical therapy for the residents. At the time of the visit LPA observed residents having lunch and enjoying musical therapy. LPA then reviewed medication storage and administration. Medications are stored in a locked cabinet in the kitchen area. Medications are being administered per physician order. LPA interviewed clients regarding their quality of care and spoke to staff present regarding care provided. The following deficiency is being cited per Title 22 Division 6 of the California Code of Regulations. This report was reviewed with the facility and a copy of this report LIC809, 809-C, LIC858, LIC859, LIC809D and Appeal Rights were read and provided to the facility.the state’s words, verbatim · CDSS document, Feb 12, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Michael Tea conducted an unannounced visit. The purpose of today’s visit was to conduct the Annual Required inspection. LPA Tea was greeted and granted entry into the facility by caregiver staff and explained the reason for the visit. Administrator (AD) Arvin Bumanglag arrived shortly to assist with the visit. Facility is licensed for six non-ambulatory residents with a hospice waiver for four. Currently there are six residents, of which three are on hospice during today's visit. LPA Tea reviewed six resident files and three staff files. Resident files and staff files for the most part contained required documentation except for one resident was missing the Personal Rights form. Administrator will have the resident’s responsible party sign the form as soon as possible. Administrator certificate expires on December, 10 2026. LPA Tea along with AD Bumanglag toured the facility at 9:38 AM. LPA toured the physical plant, checked food service, and the first aid kit. The home consists of six resident bedrooms, three bathrooms, living room, dining room, staff office area, kitchen and an attached garage. LPA observed smoke detectors/carbon monoxide in common areas and bedrooms are operational. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure and shower was free of mold/mildew. Water temperature measured between 113.5 F degrees and 116.6 F degrees. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked at time of visit. Common areas were clean and clear of hazards, and doorways were free of obstructions. First aid kit had all the required elements including dressing, bandages, tweezers, thermometer, and scissors. Kitchen was inspected. Annual inspection continued on LIC809-C Perishable and non-perishable food supply were checked and adequately stocked at time of visit. LPA observed sharps locked in a kitchen drawer. LPA also observed toxin substances to be secured and inaccessible to residents in the garage. Fire extinguishers throughout the facility are fully charged. The facility’s last disaster drill was conducted in February 13, 2025. Kitchen appliances are operational during today's visit. LPA toured the outside grounds and there are two exit gates on both sides of the house that are self-latching and operational. The backyard has a shaded table for clients to sit. LPA observed emergency supplies, food and water in the garage. Activities are based on resident’s personal preference or health condition. Facility provides activities like light exercises like walking outside and chair exercises. They also provide musical therapy for the residents. At the time of the visit LPA observed residents having breakfast and watching television. LPA then reviewed medication storage and administration. Medications are stored in locked cabineta in the kitchen area. Medications are being administered per physician order. LPA interviewed clients regarding their quality of care and spoke to staff present regarding care provided. Based on the observation made during today’s visit, no deficiencies were noted today in the areas inspected per Title 22 Division 6 of the California Code of Regulations. This report was reviewed with the facility and a copy of this report LIC809, 809-C, LIC858, LIC859, LIC9102 was read and provided to the facility.the state’s words, verbatim · CDSS document, May 28, 2025

The state marks this report as 5 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: POC

Licensing Program Analyst (LPA) Claudia Gutierrez made an unannounced Plan of Correction (POC) inspection. LPA met with Administrator (AD) Arvin Bumanglag and LPA explained the purpose of the inspection. Deficiencies 87412(a)(11), 87412(e), 1569.625(b)(1), 87411(c)(6), 1569.626(a)(1), 87468(c)(2)(A), 87465(h)(5), 87457(c)(1), and 1569.695(c) were previously cited on March 21, 2024, during facility's annual/required inspection. During today’s visit, LPA verified nine out of nine POCs for citations listed were met, and deficiencies previously cited are being cleared. Based on today’s observations, no deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted and a copy of this report was left at the facility.the state’s words, verbatim · CDSS document, May 15, 2024

Type of visit: POC

Licensing Program Analyst (LPA) Claudia Gutierrez made an unannounced case management visit for the purpose of conducting a Plan of Correction (POC) inspection. LPA met with Administrator (AD) Arvin Bumanglag and discussed the purpose of the inspection. LPA is following up on deficiencies cited on 3/21/24, during required/annual inspection. Deficiency 87465(h)(5) was cited due to resident medication not being kept in its original containers and being pre-prepared a week in advanced in a weekly medication organizer. During today's visit, LPA confirmed all resident medication is being kept in its original containers and is no longer being pre-prepared a week in advance. AD stated in-service for staff training will be conducted 4/13/24. AD will provide LPA with proof via email once completed. 87457(c)(1) was also cited due to one out of four resident files not containing an appraisal which includes an evaluation of the resident's functional capabilities, mental condition and an evaluation of social factors. AD stated resident appraisal was completed and provided LPA with completed resident appraisal dated 3/31/24. One of two deficiencies previously cited will be cleared. Based on today’s observations no deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted and a copy of this report and was left at the facility.the state’s words, verbatim · CDSS document, Apr 11, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Claudia Gutierrez made an unannounced visit for the purpose of conducting a Required/Annual Inspection. LPA was greeted and granted entry by Staff Edralyn Delos Santos and explained the purpose of the inspection. During the inspection, LPA and Staff Delos Santos conducted a tour of the inside and outside of the facility, common areas, resident rooms, kitchen, garage and observed the following: This is a one-story home with six resident bedrooms, three bathrooms, and attached two-car garage. All resident bedrooms had the required furnishings. LPA observed all client beds had linens and blankets. LPA observed all windows were screened. The backyard has a shaded sitting area. LPA observed residents in the living room and resting in their respective bedrooms. Bathrooms were observed to be free of debris and mildew, faucets and toilets were operational. Water temperature tested between 112.4-114.6 F degrees. LPA observed emergency disaster plan with means of exiting and emergency phone numbers listed and posted. Food menu was also posted and visible. LPA observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food as required by regulations. Smoke detectors and carbon monoxide detectors tested operational. Fire extinguisher was observed to be fully charged. Gas stove, microwave, washer, and dryer were observed to be operable. Sharps were observed locked in a kitchen drawer. All and any toxic chemicals, cleaning solutions, laundry toxins and disinfectants are inaccessible to clients. Medication cabinet was observed to be locked; however, medications are prepared a week in advanced and poured from their original container into a weekly medication organizer; Deficiencies were cited during today’s date. Licensee and Administrator (AD) Arvin Bumanglag arrived at 9:00 a.m. and Linh Nguyen arrived at 10:00 a.m. to assist with the inspection. (Cont. LIC809-C) LPA reviewed four resident files and three staff files. LPA observed one out of four resident pre-appraisals was not completed. Staff files did not contain documentation of 40 hours of training conducted, including six hours specific to dementia care, as required by subdivision (a) of Section 1569.626 and four hours specific to postural supports, restricted health conditions, and hospice care, as required by subdivision (a) of Section 1569.696. One out of two staff providing direct care and supervision did not complete remaining 20 hours, including six hours specific to dementia care within the first four weeks of employment. One out of two staff providing direct care and supervision does not have criminal background clearance or an exemption; Deficiencies were cited on today’s date. LPA interviewed residents and staff. Based on the observations made during today’s inspection, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations and civil penalties being assessed. See LIC421BG. An exit interview was conducted, and a copy of this report and appeal rights was left at the facility.the state’s words, verbatim · CDSS document, Mar 21, 2024

The state marks this report as 10 pages; the online copy we transcribed has 9. You can request the full file from the county licensing office.

Allegation investigated: Facility retained residents with prohibited health conditions.

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of investigating the allegation listed above. LPA was greeted and granted entry by facility caregiving staff after introducing himself and stating the purpose of the visit. Administrator Arvin Bumanglag was notified of the visit by telephone and arrived later to assist with the visit. At the time of the visit, there are four residents in care at the facility. LPA requested, obtained and reviewed resident records for all individuals in care, including their hospice file when applicable. Three out of four residents are documented to receive hospice care at this time. Following the discharge of one resident with a gastrostomy tube recently, there is a single resident present at the facility with a similar condition. Resident is confirmed to be amongst the residents admitted under hospice. CONTINUED ON FORM LIC9099-C Unfounded CONTINUED FROM FORM LIC9099 Regarding the allegation that Facility retained residents with prohibited health conditions, the following has been concluded: Based on staff and resident interviews conducted, observation of the facility's physical plant and review of records conducted during the facility visit, resident R1 is indicated to have been admitted to the facility on June 2, 2023 with a gastrostomy tube in place to address nutrition needs resulting from the resident's condition. Prior to being admitted to the facility, the resident was also admitted under hospice care on May 27, 2023. Licensee thus did not require the Department to issue an exception to Title 22 Regulations applying to prohibited health conditions. Resident is receiving adequate care and supervision from facility staff with the addition of the hospice staff based on the reviewed log of facility visits. Therefore the allegation is found to be Unfounded, meaning that the allegation is false, could not have happened and/or is without a reasonable basis. The Department has investigated this complaint. An exit interview was conducted and a copy of this report was provided to a facility representative.the state’s words, verbatim · CDSS document, Dec 8, 2023 · control 22-AS-20231207142516