Arc Facility at Richman

Type of visit: Required - 1 Year

On March 19, 2026, at 1:15PM, Licensing Program Analyst (LPA) Edward Kim conducted an unannounced required 1-Year annual visit using the CARE Inspection Tool. Upon arrival at the facility, LPA Kim was greeted and granted entry by Caregiver (CG) Lourdes Manunay. Around 1:40 PM, LPA Kim spoke with Administrator (ADMIN) Mike Adams over the phone and explained the purpose of the visit. ADMIN Adams stated they could not attend today’s visit because they were out of the country and that CG Manunay could sign on behalf of the facility. LPA also spoke with ADMIN Adams about past due licensing fees and a current balance of $4947.00. ADMIN stated they will pay the Licensing Fee, but did not provide when. The facility is licensed to operate for six (6) nonambulatory residents and has a hospice waiver for five (5) residents. The facility is a single-story structure located in a residential neighborhood. It consists of the following: four (4) resident bedrooms, two (2) staff bedroom, three (3) bathrooms, living area, foyer, dining area, kitchen, outdoor covered patio, and a detached two car garage. The prior year, there was a walk-in closet next to the kitchen, but it was changed to be a second staff room. The facility sketch shows these two staff bedrooms were once one big staff room and that wall was not part of the original sketch. LPA Kim toured inside and outside of the physical plant with CG Manunay. There were no bodies of water and no physical obstructions in the passageways. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for each resident's personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. The Resident’s rooms were inspected: Resident Room 1, Resident Room 2, Resident Room 3, and Resident Room 4. Bathrooms were found to be clean and operational. Resident bathrooms hot water temperature measured between 98.4 degrees F to 100.0 degrees F. A comfortable temperature of 78 degrees F was maintained in the facility. Evaluation Report Continues on LIC 809-C. LPA Kim observed the facility to be appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to residents. The kitchen was inspected and there is a two-day supply of perishable and seven-day supply of non-perishable food available and maintained properly. Emergency food, emergency water, and emergency supplies are stored in staff room #2. The facility has one (1) fire extinguisher that is charged and was not mounted in the kitchen. There is no service inspection date or receipt of purchase for the fire extinguisher. During the visit, LPA Kim observed the facility's infection control practices, plan of operation, and screening protocols for visitors, staff, and residents. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. A working telephone (714-870-5820) remains available. LPA Kim conducted an audit of resident files (R1-R4) and staff files (S1-S3). LPA observed R1's Appraisal Needs and Service plan was not signed and dated, and R2's Appraisal Needs and Service plan was last done on December 18, 2021. LPA observed R3 did not have a completed Physician's Report. There is a note that indicates that Kaiser refused to fill out the form. LPA did not observed 2026 staff annual training for S1-S2. The following observations were made: LPA observed there are two staff rooms at the facility, but the original facility sketch only shows one staff room. There is a wall added that was not reflected in the original sketch on file. The Fire extinguisher is not mounted and does not have an inspection service date or receipt. LPA Kim will address all of this in a subsequent visit. Due to time constraint a continuation of this inspection will be conducted at a later date. LPA will inspect all smoke and carbon monoxide detector, conduct an audit of the medication and medication administration record, staff interviews, resident interviews, a review of the evidence of liability insurance, audit of the emergency drill log, and audit of the first aid kit will be conducted. Deficiencies were cited during this visit as per Title 22 Division 6 Chapter 8 of the California Code of Regulations. LPA observed R1's Appraisal Needs and Service plan was not signed and dated, and R2's Appraisal Needs and Service plan was last done on December 18, 2021. LPA observed R3 did not have a completed Physician's Report. There is a note that indicates that Kaiser refused to fill out the form. LPA did not observe 2026 Staff annual training for S1-S2. Resident bathrooms hot water temperature measured between 98.4 degrees F to 100.0 degrees F. The facility has a past due annual licensing fees for $4947.00 that has not been paid as of March 19, 2026. An exit interview was conducted, and a copy of this report, LIC811, and LIC809D, and appeal rights were provided to Caregiver Lourdes Manunay.the state’s words, verbatim · CDSS document, Mar 19, 2026

Type of visit: Required - 1 Year

On January 2, 2025, at 9:30am, Licensing Program Analyst (LPA) Edward Kim conducted an unannounced required 1-Year annual visit using the CARE Inspection Tool. Upon arrival at the facility, LPA Kim was greeted and granted entry by Caregiver (CG) Aida Rodriguez. LPA Kim met with Administrator (AD) Mike Adams and explained the purpose of the visit. The facility is licensed to operate for six (6) nonambulatory residents and has a hospice waiver for five (5) residents. The facility is a single-story structure located in a residential neighborhood. It consists of the following: four (4) resident bedrooms, one (1) staff bedroom, three (3) bathrooms, a walk-in closet, living area, foyer, dining area, kitchen, outdoor covered patio, and a detached two car garage. LPA Kim toured inside and outside of the physical plant with AD Adams. There were no bodies of water and no physical obstructions in the passageways. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for each resident's personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. The Resident’s rooms were inspected: Resident Room 1, Resident Room 2, Resident Room 3, and Resident Room 4. Bathrooms were found to be clean and operational. A comfortable temperature of 74 degrees F was maintained in the facility. LPA Kim observed the facility to be appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to residents. The kitchen was inspected and there is a two-day supply of perishable and seven-day supply of non-perishable food available and maintained properly. Emergency food, emergency water, and emergency supplies are stored in the garage. The facility has one (1) fire extinguisher that is charged and mounted in the kitchen. Evaluation Report Continues on LIC 809-C. During the visit, LPA Kim observed the facility's infection control practices, plan of operation, and screening protocols for visitors, staff, and residents. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. The smoke detectors and carbon monoxide detectors were operable. A working telephone (714-870-5820) remains available. LPA Kim conducted an audit of resident files (R1-R5), staff files (S1-S3), and medication. LPA Kim conducted one (1) staff interview. Deficiencies were cited during this visit as per Title 22 Division 6 Chapter 8 of the California Code of Regulations. Technical violations were issued at the time of the visit. An exit interview was conducted, and a copy of this report and appeal rights were provided to Administrator Mike Adams.the state’s words, verbatim · CDSS document, Jan 2, 2025

The state marks this report as 6 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to conduct the required annual inspection. LPA was greeted and granted entry by staff. LPA explained the reason for the visit. LPA spoke with Administrator/Licensee Mike Adams and informed him of the visit. Mike Adams stated he could not be present for the visit but would be available to answer any questions. LPA and staff toured the facility. LPA observed all resident bedrooms were clean and had the required furnishings. All smoke detectors/carbon monoxide detectors tested operational. LPA observed all 3 bathrooms were clean and operational. Hot water measured 120.0 degrees Fahrenheit in all three bathrooms. LPA observed the kitchen stove top cannot light unassisted. LPA observed the stove top and the vent above the stove top are not clean and have visible grease stains. LPA observed a 2 day perishable and a 7 day non-perishable food supply on hand in the kitchen. LPA observed the knives are kept locked in a cabinet. LPA observed the medications are kept locked in a cabinet in the laundry room. LPA observed the cleaning supplies are kept locked in the laundry room. LPA observed the fireplace in the living is screened. LPA observed the PUB 475 see something say something poster is not posted in the entry way of the facility is not by 20" by 26" inches. LPA toured the backyard and garage. LPA observed the garage has beds and personal items next to the beds. LPA observed old furniture, boxes, wood, wheelchairs, walkers and chairs stored on the side of the garage and in the outdoor patio. The exit door from the backyard is latched and operational. LPA reviewed 6 out of 6 resident files. No discrepancies observed. LPA reviewed 2 staff files. LPA observed only 6 hours of training for both staff members and no CPR training for either staff member. LPA reviewed 6 out of 6 resident medications, no discrepancies observed. Deficiencies are being cited per Title 22 division 6 of the California Code of regulations. An exit interview was conducted and a copy of the report along with appeal rights was provided.the state’s words, verbatim · CDSS document, Jan 29, 2024

The state marks this report as 6 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.