Arveah's Care Homes 2

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Jill Nakagawa arrived announced at the address of 605 Connor Lane, Woodland, to make a final inspection of the facility. LPA met with Licensee/Administrator Arvin Davis. The property owner is terminating the lease agreement of the facility. Proper eviction notifications were given to the residents and/or their responsible parties and Community Care LIcensing (CCL) was informed that all residents found placements at other facilities prior to the inspection date of 11/04/2025, 10:00 AM. LPA was granted access into the facility and after a thorough inspection determined that the facility was no longer in operatio, and there were no residents. LPA collected the License. Facility will be formally closed. A copy of this report was given to Administrator/Licensee.the state’s words, verbatim · CDSS document, Nov 4, 2025

Type of visit: Case Management - Legal/Non-compliance

At approximately 2:30PM, Licensing Program Analyst (LPA) Nakagawa arrived unannounced to conduct a Case Management - Legal/Non-Compliance. LPA contacted Administrator Arvin Davis, by phone. The purpose of today's visit is to conduct a Non-Compliance (NCC) inspection. Requirements for NCC Compliance included payment of fees to California Franchise Tax Board for Arveah's Care Home #2 and #3. Licensee submitted proof of payment of all fees to Franchise Tax Board on 08/06/2025 to LPA Nakagawa. Also, NCC compliance required Resident Records are to be compliant with RCFE regulation 87506. LPA requested and reviewed records for 2 residents and found them to be complete. Finally, LPA requests proof of participation with TSP to be sent to LPA Nakagawa by 10/10/2025. In addition, during inspection of the facility it was found that the Licensee's lease agreement has been terminated and the landlord has decided to sell the facility. Licensee/Administrator failed to inform the Department of the closure and the eviction of the five residents in care within the time specified in Title 22. (See LIC 809-D). Deficiency is cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency, on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.the state’s words, verbatim · CDSS document, Oct 7, 2025

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87211(d)(1) · Plan of correction due date: Oct 7, 2025

87211ReportingRequirements(d The licensee shall notify the Department... all residents, and, if applicable, their representatives, in writing within two business days of any of the following .. knowledge thereof:This requirement is not met as evidenced by: (1) A notice of default, notice of trustee’s sale, or any other indication of foreclosure is issued on the property. Based on interview with Administrator and Staff (S1) who stated the facility would be closing due to landlord wanting to sell property, which poses a potential Health, Safety risk to residents in care.the state’s words, verbatim · CDSS document, Oct 7, 2025

Plan of correction: Licensee to submit letter to LPA stating the intention of closure. In addition Licensee will submit eviction letter for approval by CCL prior to serving residents and/or their responsible parties by close of business 10/09/2025 to LPA Nakagawa.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Jill Nakagawa conducted an unannounced Annual Required – 1 yr. inspection of this facility, which is licensed for 8, with a hospice waiver for 4. There are currently 7 residents. There were 3 care staff present at the time of inspection, 6 residents were present in the facility; 1 attending day program. Administrator was off-site at the time of inspection. LPA toured the facility on 8/21/2025 with staff; facility was found to be clean and at a comfortable temperature of 73-74 F with all exits free from obstruction. Residents' bedrooms, common areas, kitchen & food storage areas were inspected. Seven (7) smoke detectors and two (2) carbon monoxide detectors were found to be operational during the visit. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. Food stored in the kitchen refrigerator was properly stored as per regulations on this day at the time of the visit. Sharps and other items are stored inaccessible to residents in a locked drawer in kitchen. There was a supply of cleaners, hygiene products and paper products available for clients, which are locked in a drawer in supply closet, inaccessible to residents. All residents' bedrooms have lighting & appropriate furnishings, although one dresser was missing a drawer. Medications are stored in a locked cabinet in the living room; beside that is a locked refrigerator for medications requiring refrigerated storage. Continued on 809-C... Continued from 809... The water temperature in the facility measured between 111 degrees F and 117.7 degrees F. There was an ample supply of linens and hygiene products. There was not an activity calendar, but staff were observed to be interactive with residents; helping them access information on an IPad, including them with lunch preparations. There were also puzzles and games available. The facility does have a pendant system for residents to request help. Facility files have been transferred to on-line. Five resident files were inspected and LPA was unable to recover an inventory list as well as two were missing a Needs and Services Plan. Three staff files were inspected. LPA was unable to recover documentation for staff training. The following documents are requested: * LIC500 * Proof of Liability Insurance * Up-to-date Resident Roster * Employee Roster * Signed LIC308 * Proof of Control of Property * Training records for staff * Signed inventory lists for residents in care * Needs and Services Plans for residents in care Submitted to LPA by close of business 8/26/2025. There were no citations issued at this inspection. Exit interview conducted with Caregiver Jo Ann Paragoso Goodwin. A copy of this report was left as receipt.the state’s words, verbatim · CDSS document, Aug 21, 2025

Type of visit: Office

The California Department of Social Services (CDSS) Community Care Licensing (CCL) Santa Rosa Regional Office conducted an in office, Legal Non-Compliance meeting today 07/30/2025 with Arveah's Care Home 2, #576803964. Present in the meeting were: Licensing Program Manager, Kimberley Mota, Licensing Program Manager, Bethany Moellers, Licensing Program Analyst, Jill Nakagawa, and Administrator/Licensee Arvin Davis and Leah Martinez-Davis. and Wendy Martinez, via phone. The purpose of this office meeting was to discuss areas of concern in the facility operations the result of case management regarding the death of a resident in care by the Department and putting Arveah's Care Home 2 on a Non-Compliance Conference (NCC) plan. On 04/02/2025 Licensee was cited for violating California Code of Regulations (HSC) Title 22, § 1569.269 (a)(6)Enumerated rights. Parties present during the meeting agreed to a NCC plan for 1 year ending 07/30/27 to bring the facility into compliance. Items addressed during the meeting include, but are not limited to, areas of concern: Compliance with California Title 22 Regulations and Community Care Licensing (CCL) Requirements Recent Violation of Resident's Enumerated Rights The Licensee was informed that an additional civil penalty might be assessed based on Health and Safety Code 1569.49(e) or (f), 1548(e) or (f), 1568.0822(e) or (f). Technical Support Provider (TSP) assistance was offered to Licensees during this meeting. Administrator/Licensee was informed that civil penalties are under review by the Department per Health and Safety Code 1569.49(f), 1548, or 1568.0822. Exit interview conducted with Administrator/Licensee, whose signature on form confirms receipt of documents. Continued from 809... Technical Support Provider (TSP) assistance was offered to Licensees during this meeting. Administrator/Licensee was informed that civil penalties are under review by the Department per Health and Safety Code 1569.49(f), 1548, or 1568.0822. Exit interview conducted with Administrator/Licensee, whose signature on form confirms receipt of documents.the state’s words, verbatim · CDSS document, Jul 30, 2025

Type of visit: Office

On April 02, 2025 Licensing Program Analyst (LPA) Nakagawa, Licensing Program Manager (LPM) Mota held an announced office meeting and met with Licensee’s Arvin Davis and Leah Davis and staff Wendenberg Martinez. The purpose of the in-formal office meeting was to discuss a self-reported incident involving the death of Client (C1). On 9/13/24, the department received a self-reported incident report of the death of C1 after choking on food. The Department conducted an investigation along with the Deputy Coroner for Yolo County, Individual I1 (I1) into C1’s death. I1 was notified by the Coroner, a sausage about 2 ½ inches long was lodged in C1’s throat. I1 stated based off of C1’s difficulty with swallowing and eating behaviors, it would be “common sense not to feed C1 sausages.” I1 determined the cause of death was accidental and the manner of death was accidental. I1interviewed C1’s doctor who did not qualify a sausage as “soft food.” Per C1’s death certificate, C1 passed away on 9-07-2024 due to “Choking,” Per staff, C1 tended to shovel food and swallow food whole. The facility implemented a mechanically soft diet for C1 to limit them from choking as they had several incidents prior (Note: Foods must be soft-textured foods that require minimal chewing). Staff fed C1 a hotdog for breakfast on 9-07-2024, which C1 choked on, and ultimately passed away. Staff admitted C1 has had choking incident in the past with hotdogs and sausage like foods, but staff continued to feed hotdogs to C1. The facility failed to follow C1’s food orders, which they implemented for C1, resulting in C1’s death. Continued on 809-C... Continued from 809.... The Department conducted interviews with Staff (S1) who stated “Staff had to watch C1 closely around meals times as C1 would grab food off the counter or other peoples’ plates and shovel food into their mouth and that C1 had a mechanically soft diet”. In addition, S1 stated “staff informed S1 that C1 has choked on sausage in the past one time. The staff was able to do a few back slaps and they were able to dislodge the sausage” Interviews conducted with Staff (S2) who stated “S2 was feeding C1 breakfast. S2 was feeding C1 a hotdog as they ran out of breakfast sausage. S2 cut the hotdog in half picked up one piece on a fork, fed it to C1. C1 chewed the piece with no issues. S2 gave C1 the other half of the hotdog, and C1 started choking. S2 stated when C1 was first admitted into the facility, they could feed themself, but C1 began to grab food off the counter and shovel food into their mouth. Since C1 started this behavior, staff started to feed C1”. Based on the Departments and Yolo County Coroner’s observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED. Health & Safety Code 1569.269(a)(6) is being cited on the attached LIC809-D. An immediate civil penalty is being assessed today in the amount of $500 for a violation that resulted in the sickness or injury of a resident in care. The licensee was informed that an additional civil penalty might be assessed based on Health and Safety Code 1569.49(e) or (f), or 1548(e) or (f), 1568.0822(e) or (f).the state’s words, verbatim · CDSS document, Apr 2, 2025

From the deficiency page — Deficiency type: Type A · Section cited: HSC 1569.269(a)(6) · Plan of correction due date: Apr 2, 2025

1569.269 (a)(6)Enumerated rights; severability...To be accorded safe, healthful, and comfortable accomodations...This requirement is not met as evidenced by: Based on the Departments/Coroners investigation the... Licensee failed to ensure C1 care, supervision, and services that meet their individual needs and are delivered by staff that are sufficient in numbers, qualifications, and competency to meet their needs which resulted in C1 death which poses an immediate health and safety risk to residents in care.the state’s words, verbatim · CDSS document, Apr 2, 2025

Plan of correction: Licensee will ensure that all staff are trained on the needs and services of residents, including the special needs of residents with swallowing issues and other dietary needs. Licensee/Administrator to arrange a training for staff by a third party licensed professional by 04/3/2025.Licensee will submit proof of training by all staff at the facility by 04/10/2025.

Type of visit: Case Management - Incident

Licensing Program Analyst (LPA) Jill Nakagawa arrived unannounced to conduct an inspection and gather documentation regarding an incident at the facility. There were 2 care staff and 4 residents on site at the time of the inspection Two residents were attending their Day Programs. LPA found the facility to be clean and well-organized. Care staff were busy attending the needs of the residents and preparing lunch. LPA requested resident records and staff were unable to access them on line or on site. LIcensee Leah Davis (LD) was contacted by LPA. LD reported that she has been working to transfer information via software programs but there were no records on site. A technical advisory had been issued regarding this issue on 8/13/2024, with records able to be accessed by 8/16/2024. LPA informed LD that the regulation has not been met. (See LIC 809-D). Deficiency is cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency, on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.the state’s words, verbatim · CDSS document, Sep 24, 2024

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87506(d) · Plan of correction due date: Sep 24, 2024

87506 Resident Records - All resident records shall be available to the licensing agency to inspect, audit, and copy upon demand during normal business hours. This requirement is not met as evidenced by: Based on observation, interview and record review, the licensee did not comply with the section cited above not having records available for Licensing to review during visit which poses a potential health and safety risk to persons in care.the state’s words, verbatim · CDSS document, Sep 24, 2024

Plan of correction: Administrator agrees to submit self certification that all resident/staff files are accessible for review and contain all required documents by POC due date, 9/27/2024.

Type of visit: Case Management - Annual Continuation

Licensing Program Analyst (LPA) Jill Nakagawa arrived unannounced to conduct an Annual - Continuation Inspection to review the resident and staff records. LPA was allowed entry by care staff . LPA was unable to inspect files due to technical difficulties. LPA and Licensee discussed the importance of having staff and resident files available for review at all times. Licensee will recover all files for LPA's review by 08/16/2024. A technical advisory was issued. No citations were issued at the time of inspection.the state’s words, verbatim · CDSS document, Aug 13, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Jill Nakagawa conducted an unannounced Annual Required – 1 yr. inspection of this facility, which is licensed for 8, with a hospice waiver for 4. There are currently 7 residents, one of whom is on hospice care. There were 2 care staff present at the time of inspection, 4 residents were present in the facility, 2 attending day program and one at an appointment. One home health nurse was also at the facility during inspection. LPA toured the facility on 7/26/2024 with staff; facility was found to be clean and at a comfortable temperature of 71 F with all exits free from obstruction. Residents' bedrooms, common areas, kitchen & food storage areas were inspected. Seven (7) smoke detectors and two (2) carbon monoxide detectors were found to be operational during the visit. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. Food stored in the kitchen refrigerator was properly stored as per regulations on this day at the time of the visit. Sharps and other items are stored inaccessible to residents in a locked drawer in kitchen. There was a supply of cleaners, hygiene products and paper products available for clients, which are locked in a drawer in supply closet, inaccessible to residents. All residents' bedrooms have lighting & appropriate furnishings. Medications are stored in a locked cabinet in the living room; beside that is a locked refrigerator for medications requiring refrigerated storage. Continued on 809-C... Continued from 809... The following documents are requested: * LIC500 * Proof of Liability Insurance * Up-to-date Resident Roster * Employee Roster * Signed LIC308 * Proof of Control of Property Staff and Resident Records will be inspected at a later time. There were no citations issued at this inspection. Exit interview conducted with Caregiver Jo Ann Paragoso Goodwin. A copy of this report was left as receipt.the state’s words, verbatim · CDSS document, Jul 26, 2024

The state marks this report as 7 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.