Araville Residential Care Home II

Type of visit: Required - 1 Year

On July 29, 2026, Licensing Program Analyst (LPA) Murial Han conducted an unannounced annual inspection. Upon arrival, LPA met with caregiver, Mila De Villa and explained the purpose of today's visit. The administrator and the assistant administrator arrived shortly thereafter and assisted with the inspection. A tour of the facility was conducted with caregiver. This is a single story facility with 6 bedrooms (1 staff rooms, 4 private rooms and 1 shared rooms), 2 full and 1 half bathroom/shower rooms. Living room, dining area, kitchen and all other areas intended for resident use were observed to be furnished and able to meet the needs of the residents. The indoor and outdoor passageways were free of obstruction. Food supplies were sufficient of 2- days perishables and 7- days of non-perishables. Showers were observed equipped with non-skid mats and grab bars. During the tour of the facility, LPA observed room 5 and the bathroom next to room had a strong urine odor. This observation was also made during the annual inspection last year. Comfortable temperature is maintained and lighting is sufficient for comfort. Bed sheets, linens, and towels were observed to be sufficient and able to meet the needs of the residents at this time. Central storage for medications, sharps and chemicals were observed to be locked and inaccessible to residents in care. Hot water temperature in the bathroom and kitchen was 114- 116 degrees F. Fire extinguisher were checked. Emergency Disaster drills were reviewed to be adequate. A review of (6) resident files was conducted and noted on the LIC 858 and during the file reviews LPA observed R1 has half bedrails without a physician's order and R2 and R3 have bedrails by the bed and the foot of their beds. Based on observation, deficiency is cited under California Code of Regulations, Title, 22 cited on the LIC 809D. Failure to correct the deficiencies may result in civil penalties. This report is reviewed and discussed with the assistant administrator, Amie Flores; A copy of this report and the appeal rights were provided.the state’s words, verbatim · CDSS document, Jul 29, 2026

Type of visit: Required - 1 Year

On July 1, 2025 Licensing Program Analyst (LPA) Murial Han conducted an unannounced annual inspection. Upon arrival, LPA met with caregiver, Mila De Villa and explained the purpose of today's visit. The administrator and the assistant administrator arrived shortly thereafter and assisted with the inspection. Current census is 5 residents. A tour of the facility was conducted with caregiver. This is a single story facility with 6 bed rooms (1 staff rooms, 4 private rooms and 1 shared rooms). Living room, dining area, kitchen and all other areas intended for resident use were observed to be furnished and able to meet the needs of the residents. The indoor and outdoor passageways were free of obstruction. Food supplies were sufficient of 2- days perishables and 7- days of non-perishables. Showers were observed equipped with non-skid mats and grab bars. LPA observed the bathroom next to R5's room had a strong urine odor. Comfortable temperature is maintained and lighting is sufficient for comfort. Bed sheets, linens, and towels were observed to be sufficient and able to meet the needs of the residents at this time. Central storage for medications, sharps and chemicals were observed to be locked and inaccessible to residents in care. Hot water temperature in the bathroom and kitchen and fire extinguisher were checked. A review of (5) resident files was conducted and noted on the LIC 858. A review of (2) staff files was conducted and noted on the LIC 859. LPA requested for a copy of the control of property to be submitted to CCL 7/2/2025. A civil penalty of $500 is being assessed today for 2 repeat violations that were cited during the annual inspection last year. Based on observation, deficiency is cited under California Code of Regulations, Title, 22 cited on the LIC 809D. Failure to correct the deficiencies may result in additional civil penalties. This report is reviewed and discussed with the administrator/licensee. A copy of this report and the appeal rights were provided.the state’s words, verbatim · CDSS document, Jul 1, 2025

Allegation investigated: Licensee did not provide a refund upon resident's death

On March 17, 2025 Licensing Program Analyst (LPA) Murial Han conducted an unannounced 10-day complaint investigation. LPA met with caregiver, Mila De Villa and explained the purpose of today's visit. Caregiver called and informed manager, Amie Flores of LPA's visit. Regarding to the allegation of- licensee did not provide a refund upon resident's death, the reporting party stated that resident-in-question (R1) passed away on 12/25/2024 and the responsible party has not gotten the refund. During today's visit, LPA interviewed the manager over the phone and she stated that the Licensee's son is handling the refund and he is planning to refund the money this month. LPA reminded the manager that per Title 22, the refund shall be issued within 15 days after the personal property is removed. After the investigation, this allegation is substantiated. Based on interview, during the investigation, the preponderance of evidence standard has been met. Therefore, this allegation was determined to be substantiated. Deficiencies of the California Code of Regulations, Title, 22 cited on the LIC9099-D. Failure to correct the deficiencies may result in civil penalties. Report was discussed with caregiver and a copy is provided with Appeal Rights. Substantiatedthe state’s words, verbatim · CDSS document, Mar 17, 2025 · control 14-AS-20250311150516

From the deficiency page — Deficiency type: Type B · Section cited: HSC 1569.652(c) · Plan of correction due date: Mar 24, 2025

Health and Safety Code section 1569.652 provides in part:..(c) A refund of any fees paid in advance covering.. within 15 days after the personal property is removed. This requirement is not met as evicenced by based on interivew, R1 passed away on 12/25/24 and the refund has yet been issued which poses a potential health and safety risk with residents in care.the state’s words, verbatim · CDSS document, Mar 17, 2025

Plan of correction: The administrator/licensee shall review the regulation and provide a statement in writing acknowledging the review and provide a copy of proof that the refund was issued. The administrator/licensee will provide a copy of the proof and the written statement to CCL by 3/25/2025.

Allegation investigated: Facility staff are not serving food in a safe and healthful manner. Facility staff are not ensuring that incontinent residents are kept clean and dry. Facility staff are withholding fluids to control incontinence. Facility staff are not properly trained resulting in injuries to the resident.

On September 19, 2024 Licensing Program Analyst (LPA) Murial Han conducted an unannounced visit to delivery the complaint investigation findings. LPA met with caregiver Mila De Villa and explained the purpose of today's visit. Regarding to the allegation of - facility staff are not serving food in a safe and healthful manner, the reporting party stated that the food is being served cold. As part of the investigation, LPA interviewed resident-in-question(R1), other residents and staff. According to R1 and the other residents, they were not being served cold food. They stated that the food is good and one of the residents stated that sometimes the food was served luke warm but it was never cold and staff would heat it up if they requested for it. According to staff, the food was not cold and if the residents wanted it warmer, they would heat it up. After the investigation, this allegation is deemed to be unsubstantiated. Unsubstantiated Regarding to the allegation of facility staff are not ensuring that incontinent residents are kept cleaned, the reporting party stated that resident #1 (R1) is only being changed 2x/day. As part of the investigation, LPA conducted observation, interviewed staff, visiting home health licensed professional, and other residents. During LPA's visit on 8/14/2024, LPA observed R1 who was laying in bed, appeared with bright affect, and cleaned. According to staff, they changed R1 2-3x/day and as needed. They also stated that they checked on R1 several times a day to make sure R1 was cleaned and dry. According to the visiting home health licensed professional, R1 was always cleaned and dry during their visits. The other residents stated that facility staff are cleaning and changing them when needed and sometimes it took a little longer when they were busy. After the investigation, this allegation is deemed to be unsubstantiated. Regarding to the allegation of- facility staff are withholding fluids to control incontinence, the reporting party stated R1 was not being provided with water/fluids and the responsible party has to provided during visits. As part of the investigation, LPA conducted observation, interviewed R1, other residents and staff. During LPA's visit on 8/14/2024, LPA observed R1's water bottles were placed in R1's room and other residents have their water bottles next to their beds as well. According to staff, R1 needed assistance with drinking water so they placed the water bottles in the room and offered it during meals, and through-out the day. The also stated that they would fill-up all the resident's water bottles when needed. LPA interviewed R1 who stated that staff would ensure that he/she has water through-out the day and the other residents also stated that they always have water next to their beds. After the investigation, this allegation is unsubstantiated. Regarding to the allegation of- facility staff are not properly trained resulting in injuries to the resident, the reporting party stated that R1's responsible party noted bruises on R1's fingers and arms. As part of the investigation, LPA reviewed staff training records, R1's medical records, interviewed staff, administrator, and other residents. LPA interviewed the administrator who denied the allegation and stated R1 has been at the facility for several years and the responsible party has not reported that staff was not trained resulting bruises on R1's fingers and arms. In addition, the administrator stated that facility staff members are experienced and trained to care for the residents. LPA interviewed staff member who denied the allegation and stated that they have been caring for R1 for many years and they were familiar with R1's skin condition, medications, daily routines, etc. They stated that R1 is at risk for bruises due to a medication that R1 is taking and has been taking it for many years. LPA interviewed the visiting home health licensed professional who stated that R1 was prone to bruises/skin discoloration due to age and a medication that R1 was taking. The home health licensed professional also stated that based on his/her observation, facility staff members were competent and trained to care for the residents and they were providing good care. LPA interviewed other residents and they stated that staff members were professional, caring and knowledgeable of their jobs. Based on the training records provided by the facility, LPA observed facility staff completed their annual training. Based on R1's Centrally Stored Medication And Destruction Record, LPA observed R1 is taking the medication that was reported by the staff and according to Mayo Clinic, one of the side affects of this medication is bruising or purple areas on the skin. After the investigation, this allegation is deemed to be unsubstantiated. Although the above investigations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is UNSUBSTANTIATED. This report is reviewed and discussed with the caregiver, Mila De Villa.the state’s words, verbatim · CDSS document, Sep 19, 2024 · control 14-AS-20240813105045

Type of visit: Required - 1 Year

On July 17, 2024 Licensing Program Analyst (LPA) Murial Han conducted an unannounced annual inspection. Upon arrival, LPA met with caregiver, Mila De Villa and explained the purpose of today's visit. The administrator and the assistant administrator arrived shortly thereafter and assisted with the inspection. Current census is 4 residents. A tour of the facility was conducted with caregiver. This is a single story facility with 6 bed rooms (2 staff rooms, 2 private rooms and 2 shared rooms). Living room, dining area, kitchen and all other areas intended for resident use were observed to be furnished and able to meet the needs of the residents. The indoor and outdoor passageways were free of obstruction. Food supplies were sufficient of 2- days perishables and 7- days of non-perishables. Toilet, hand washing and bathing areas were observed clean and in operating condition. Showers were observed equipped with non-skid mats and grab bars. Comfortable temperature is maintained and lighting is sufficient for comfort. Bed sheets, linens, and towels were observed to be sufficient and able to meet the needs of the residents at this time. Central storage for medications, sharps and chemicals were observed to be locked and inaccessible to residents in care. Hot water temperature in the bathroom and kitchen were measured at 105- 115 degrees Fahrenheit. Fire extinguisher was checked. A review of (4) resident files was conducted and noted on the LIC 858. A review of (3) staff files was conducted and noted on the LIC 859. LPA requested for a copy of the Liability Insurance, control of property, and administrator certification to be submitted by 7/18/2024. Based on observation, deficiency is cited under California Code of Regulations, Title, 22 cited on the LIC 809D. Failure to correct the deficiencies may result in civil penalties. . This report is reviewed and discussed with the administrator and the assistant administrator. A copy of this report and the appeal rights were provided.the state’s words, verbatim · CDSS document, Jul 17, 2024

Type of visit: Required - 1 Year

Unannounced annual visit made out to this facility on 11/18/2023 by Licensing Program Analyst (LPA) Charlie Yang who was met by the facility live-in caregivers, Rodrigo Mumanglag and Elma Dajao, who were briefly interviewed at this time. This LPA requested that they go ahead and contact the facility designated Administrator, Dorie Paniza, to inform her that CCL was present at this time for an annual visit. She was unable to be present at today's annual visit but gave consent for her present caregivers to sign all documents at this time. Current census was 6 residents. There was one resident under the care of hospice at this time according to statements made by the facility caregivers. This facility does have an approved hospice waiver to be able to accept and retain up to (2) hospice residents at any given time. Tour of this facility was conducted. A tour of the facility kitchen area was conducted. Drawers and cabinets were opened and the items enclosed were reviewed at this time. Drawers housing knives and sharps were observed to be locked and made inaccessible to the residents at this time. Cleaning agents, bleach, and other supplies were observed to be locked and made inaccessible to the residents at this time. A review of the facility food supply was conducted. A review of the facility's 2-day perishable foods and 7-day nonperishable foods was conducted to make sure that there were sufficient quantities on hand at all times. Medication cabinet, located in the facility staff room, was reviewed. Policies and procedures involving handling, dispensing, and documentation of the resident medications were discussed with the facility staff at this time. A review of the facility Medication Administration Record and dispensing log was conducted. Medication cabinet was observed to be locked and made inaccessible to the residents at this time. Living room, dining area, and all other areas intended for resident use were observed to furnished and maintained in compliance at this time and able to meet the needs of the residents. A tour of the resident bedrooms was conducted. Furniture and furnishings were observed to be sufficient and able to meet the needs of the residents at this time. A tour of the resident restrooms was conducted. Grab bars and non skid mats were observed to be presentand in good repair at this time. Hot water temperatures were taken to make sure that they measured within the allowed range of 105-120 degrees at all times. Laundry area, located in the garage, was observed to be unlocked but did not house any detergents, soaps, or bleach at this time. It was learned that all cleaning and laundry supplies were separately locked and made inaccessible to the residents at all times. Linen closet was reviewed. Bed sheets, linens, and towels were observed to be sufficient and able to meet the needs of the residents at this time. A tour of the garage area was conducted. Additional food storage units were observed to be present and in good repair at this time. Additional nonperishable food supplies were observed to be present along with emergency food supplies as well. First aid kit, located in kitchen area, was observed to be present and contained all of the required components at this time. Fire extinguisher was observed to be placed in the kitchen area at this time. A tour of the exterior grounds for this facility was conducted. A review of the facility perimeter fence, side gates, and exits was conducted. A review of (6) resident files was conducted and noted on the LIC 858. A review of (4) resident staff files was conducted and noted on the LIC 859. The following forms and documents were requested to be updated and submitted into CCL in order to update this facility file: LIC 308 LIC 400 LIC 500 LIC 610 The following deficiencies were observed and cited on the following LIC 809-D pursuant to Title 22 Rules and Regulations, Health and Safety Codes. Appeal Rights were printed and a copy was given to the facility representative at this time. Exit Interviewthe state’s words, verbatim · CDSS document, Nov 18, 2023