Routine inspection·January 14, 2025

This LIC809 was created at 3:00pm on 01/13/2025. LPA arrived to the facility at 8:30am and ended the visit at 10:45am. LPA conducted the Required-1 Year visit but was unable to open a Facility Evaluation Report (LIC809) due to Program being down. The following was provided to Administrator Irvin Harris on the attached Word document: Facility Name: Casa De Los Arboles Time Began: 8:30am Administrator: Roy Sweeny Time End: 10:45am Address: 6482 Via Arboles, Anaheim Hills, CA 92807 Capacity: 6 Census: 5 Type of Visit: Required 1-Year Met With: Irvin Harris C. Mendoza ------------------------------------------------------------------------------------------------ Licensing Program Analyst (LPA) Lydia Martinez made an unannounced Required 1 – Year inspection at this facility. LPA introduced herself and stated the purpose of the visit. LPA was granted entry into the facility by Caregivers Rodelio Manalo and Marlawm Logrono. Administrator Irvin Harris arrived shortly after. LPA, along with AD Harris conducted a tour of the inside and outside of the facility. LPA spoke with 3 of the 5 residents during today’s visit. LPA observed residents to be clean and warm. Facility was observed to be clean and in good repair and is kept at a comfortable temperature for the residents in care. LPA reviewed 5 resident files and 2 staff files during today’s visit. Medication was observed to be in a centrally stored location and medication reviewed appeared to have been dispensed accurately. Due to computer glitch, LPA is unable to leave a Facility Evaluation Report (LIC809). LPA reviewed this report with AD Harris and copy was sent to AD's email for signature. (see LIC809C) On 01/14/2025, there are 5 Residents and 3 staff present during the visit. One resident is receiving Hospice care. LPA toured the physical plant. LPA observed the facility to be clean, sanitary and in good repair. The home is maintained at a comfortable temperature. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each Resident comfortably. Bathrooms were checked, toilets/water faucets worked properly and shower was free of mold/mildew. Hot water temperature was within regulatory requirements. Bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards, doorways were free of obstructions. Kitchen is clean and organized. Perishable and non-perishable food supply was checked and adequately stocked. LPA observed sharps and cleaning supplies are inaccessible to the Residents. Smoke detectors and carbon monoxide detector tested operational; Fire extinguisher was fully charged and mounted. No bodies of water were observed outside. Walkways around the home were clear of hazards. Exit gates are unlocked and self-latching. Patio table with chairs was observed. There is no record of Emergency/Fire Drills being conducted. LPA observed emergency supplies, including food and water. LPA observed a twin bed and personal belongs in storage room connected to the dining room. Per AD, room is being used as a staff room. LPA observed the half of the single car garage was converted into a staff room and office. The Fire Clearance granted on 12/14/2017 states "Garage shall be used for vehicles only. Garage shall not be used for any habitable space." Based on observations made during the visit conducted on 01/13/2025 the following deficiency is being cited. This report was discussed with the facility Representative and a copy of LIC809, LIC809C, LIC809D Appeal Rights were sent to email on file.