Soliven Care Home

Allegation investigated: Facility failed to report and provide updates on the residents health status.

Regarding the allegation: Facility failed to report and provide updates on the residents health status. During the investigation, it was confirmed by S1, there was a breakdown in communication and the family of R1 was not informed about the residents change in condition. Facility staff did not inform the responsible person about the swelling to the residents legs that led to the residents hospitalization. S1 also confirmed there was no incident report sent to the Regional Office regarding the hospitalization of R1. Based on the evidence gathered through interviews, and document review the preponderance of evidence standard has been met, therefore, the allegation above is found to be SUBSTANTIATED. A violation is being cited per California Code of Regulations Title 22. An exit interview was conducted, and a copy of this report and appeal rights were provided. Substantiatedthe state’s words, verbatim · CDSS document, Oct 28, 2025 · control 22-AS-20251020134502

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87211(1)(D) · Plan of correction due date: Oct 31, 2025

87211 Reporting Requirements (1) A written report shall be submitted... within seven days of the occurrence of any of the events specified... below. This report shall include the resident's name, age, sex and date of admission; date and nature of event; attending physician's name, findings, and treatment, if any; and disposition of the case. (D) Any incident which threatens the welfare, safety or health of any resident, such as psychological abuse of a resident by staff or other residents, or unexplained absence of any resident. This requirement is not being met as evidenced by: The admission by Licensee Soliven, that the responsible party was not notified regarding R1’s change in condition and there was no incident report sent to the department regarding R1’s hospitalization.the state’s words, verbatim · CDSS document, Oct 28, 2025

Plan of correction: Licensee Soliven agrees to review the reporting requirements and email LPA Haley a signed statement of acknowledgement and understanding of the reporting requirements. Licensee Soliven will also inform LPA who will be the primary person responsible for reporting incidents to the department and the back up person responsible, in case the primary person is unavailable. POC is due by 4:00pm on the POC due date.

Allegation investigated: Lack of care and supervision led to pressure injury

Licensing Program Analyst (LPA) Jerome Haley made unannounced visit regarding the complaint allegations above. LPA Haley was greeted, granted entry and explained the reason for the visit before entering the facility. During the visit LPA Haley toured the facility, interviewed staff, witnesses, and collected and reviewed relevant documents. Regarding the allegation: Lack of care and supervision led to pressure injury 0 of 6 individuals interviewed could provide any supporting evidence or information related to the pressure injury sustained while in care. Interviews were conducted with facility staff, medical professionals, and hospital documents were reviewed. 2 facility staff did confirm there was some redness observed on resident 1’s (R1) buttocks; however, both staff denied there was any break of the skin. R1 was sent to the hospital on October 13, 2025, for swelling to the legs. Continued on LIC9099C Unsubstantiated A review of the hospital discharge summary for R1 did not mention anything about a pressure wound or pressure ulcer. The discharge summary states the resident was diagnosed with DVT of lower extremity, bilateral history of dementia, and leg pain-swelling. Based on the information gathered during the investigation through interviews and document review, the Department is unable to ascertain if the allegation occurred as reported. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove or refute the alleged violation occurred; therefore, the allegation is deemed Unsubstantiated.the state’s words, verbatim · CDSS document, Oct 28, 2025 · control 22-AS-20251020134502

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Jerome Haley conducted an unannounced visit for the purpose of conducting a required one-year annual inspection. LPA was greeted, granted entry by staff and explained the reason for the visit. Structure: The facility is a single level structure and licensed for six non-ambulatory residents, of which one may be bedridden. As of today, the facility has five residents admitted to the facility. All of the residents were present during at the beginning of the visit, before one left for day program. There’s a total of 5 bedrooms (3 resident & 2 Staff) and 2 bathroom (1 resident & 1 staff) areas for residents. There’s a living room space, a dining space, backyard and an attached garage. Bedrooms: All bedrooms have the required furnishings: bed, lamp, chair, and storage space. Bathroom(s): Bathrooms are equipped with a working toilet, wash basin, and shower. Hot water was measured at 106.8 degrees F. Kitchen: 4 of 4 burners are operational on the gas stove. Sharps are kept locked under the sink. Cleaning chemicals are stored in a locked cabinet above the washer. A dryer is located in the kitchen across from the washer. Food Service: A supply of perishable and non-perishable food items that meet regulation requirements was observed. Client & Staff Files: Resident and staff files are stored in the locked closet near the entrance of the facility. File Review: 4 of 5 resident files were reviewed during the visit, and 3 staff files were reviewed. Medications/First-Aid Kit: Resident medications are stored in the locked medication closet. A first aid kit was also observed. Medication Review: 3 of 5 resident medications were reviewed during the visit. Continued on LIC809C Linens & Hygiene Supplies: Hygiene items were observed in the bathroom areas in a locked cabinet space. Garage Area: The garage is used as a storage area. Miscellaneous facility items were observed, like bed frames, mattresses, wheelchairs, walkers, and a bike. Staff items are stored in locked storage areas along the outer edges of the garage. The Licensee/ was advised to keep walkways clear and free of clutter. Licensee understood and showed LPA recently bout shelves that will be assembled in the garage to help keep it organized. Backyard/Exterior: The backyard has a shaded patio area with a table and chairs. There were furniture items no longer being used under the patio area that need to be removed. Photos were taken. Other deficiencies were observed and photographed. See LIC9099D dated (10.28.25). LPA discussed other backyard housekeeping needs, that will assist in preventing future violations. The licensee/Administrator understood. Bodies of Water: None. Smoke/Carbon Monoxide Detectors: Smoke and carbon monoxide detectors tested operational. Fire Extinguisher: Fire extinguisher was observed mounted in the kitchen. An emergency evacuation drill: Evacuation drills was conducted July 19, 2025. Drills are conducted quarterly. Emergency Phone Numbers, House Rules, Exit Plan & Menu: Facility postings are posted are available for review on the main postings board at the entrance of the facility. Additional Comments: Licensing fees are current. During the visit, 3 of 5 resident files were reviewed, 3 of 5 resident medications were reviewed and 3 staff files were reviewed during the visit. Facility contact information was updated during the visit. Deficiencies observed during the inspection will be cited. An exit interview conducted, and a copy of the report and appeal rights were provided.the state’s words, verbatim · CDSS document, Oct 28, 2025

Type of visit: Case Management - Annual Continuation

Licensing Program Analyst (LPA) Cynthia Chan conducted a subsequent visit to finish the annual inspection. LPA arrived unannounced and met with Staff, Irene Plascencia. Administrator, Joselolito Soliven, arrived shortly after to assist with the visit. The initial inspection began on 12/9/24. During the visit today, LPA conducted the remainder of domains from the CARE tools. Staffing: The administrator's (Joselolito Soliven) certificate expired on 8/15/24, however, LPA verified that the renewal documents were received by the department. Staff employed are over the age of 18 and are fingerprint cleared. Per the administrator, there is backup staff if needed. Personnel Records-Training: Staff files are maintained at the facility. LPA reviewed the Administrator and 2 other staff files. There are sufficient annual training on file. CPR & First Aid certificates are current for all 3 staff. Resident Records-Incident Reports: Resident files are maintained at the facility. LPA reviewed all 5 resident files and the documents are in their files - Admission Agreements, Identification & Emergency Information, Physician's Report, and Resident rights. LPA issued a technical violation for the preadmission appraisal which was not found in their files. Resident Rights-Information: The Local Ombudsman and Residents personal rights information are posted at the facility. Incidental Medical & Dental: Medications are centrally stored and locked in the storage cabinet. All resident medications were reviewed and there were no discrepancies found. Residents with Special Health Needs: The facility accepts and retains residents with dementia and/or hospice. There are currently no residents on hospice. No deficiencies were given, however, technical violations were issued. An exit interview was held and a copy of this report was given to the administrator.the state’s words, verbatim · CDSS document, Dec 19, 2024

The state marks this report as 3 pages; the online copy we transcribed has 1. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Cynthia Chan conducted the annual inspection on 12/9/24. LPA arrived unannounced and met with Staff, Irene Plascencia. Administrator, Joselolito Soliven, arrived shortly after to assist with the visit. The facility is licensed to serve 6 non-ambulatory residents, ages 60 and over, of which 1 may be bedridden. There is a hospice waiver approved for 6 residents. LPA used the Compliance and Regulatory Enforcement (CARE) tools to inspect the facility. The following domains were completed today. Infection Control: Facility has an Infection Control plan and are continuing to clean and disinfect the home. They are using appropriate hand hygiene and wearing gloves while assisting residents. Operational Requirements: The facility accepts and retains residents diagnosed with dementia. There are no residents utilizing oxygen at this time. Facility has the required amount of liability insurance coverage. Physical Plant & Environment Safety: The facility consists of 3 resident bedrooms, 2 Staff rooms, 2 bathrooms, living room, dining room, kitchen, and a garage. The hot water temperature was measured between the required range of 105-120 degrees F. There are no swimming pool or bodies of water on the premises. The fireplace is adequately screened. There are smoke and carbon monoxide combo detectors located throughout the home. Knives and disinfectants are locked. Food Service: Sufficient food supplies of 2-day perishable and a week of non-perishable items are observed. The foods are properly stored in the refrigerators. Planned Activities: Facility has sufficient space to provide indoor and outdoor activities. Disaster Preparedness: Facility has the updated Emergency Disaster Plan and procedures are outlined in the plan. No deficiencies are issued today. LPA will return another day to inspect the rest of the domains. An exit interview was held and a copy of this report was given to the administrator.the state’s words, verbatim · CDSS document, Dec 9, 2024

Allegation investigated: Facility is not allowing a resident to have visitors.

Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. conducted an unannounced initial 10-Day complaint visit to initiate the investigation into the above allegation and to deliver the findings of the investigation. LPA was greeted and granted entry into the facility and met with Caregiver Maria Carmen Zuniga. LPA explained the reason for the visit. Administrator (AD) Joselolito Soliven arrived shortly after. This agency has investigated the complaint alleging that facility is not allowing a resident to have visitors. LPA Ramirez conducted file reviews and interviews and obtained copies of pertinent documents. Regarding the allegation, the following was revealed: Two of five individuals interviewed confirmed the allegation. During the course of the interviews with residents, Resident 1 (R1) reported that their friend can visit anytime. During the interviews the AD reported that he told R1's friend that he needed to contact the Power of Attorney (POA) before visiting R1. Per AD the POA has to be informed prior to R1 having visitors. CONTINUED ON LIC9099-C... Substantiated Based on LPA observations and the interviews which were conducted, the preponderance of evidence standard has been met, therefore the following allegation: facility is not allowing a resident to have visitors is deemed SUBSTANTIATED. California Code of Regulations, Title 22, Division 6, Chapter 8 is being cited on the attached LIC 9099D An exit interview was conducted with AD Soliven and a copy of this report along with the Appeal Rights were provided at the time of this visit.the state’s words, verbatim · CDSS document, Aug 1, 2024 · control 22-AS-20240725145144

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87468.1(a)(11) · Plan of correction due date: Aug 5, 2024

Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (11)To have their visitors...permitted to visit privately during reasonable hours and without prior notice, provided that the rights of other residents are not infringed upon. This requirement is not met as evidenced by: During the course of the interviews the AD reported that he told R1's friend that he needed to contact the Power of Attorney (POA) before visiting R1.the state’s words, verbatim · CDSS document, Aug 1, 2024

Plan of correction: Licensee/Administrator agrees to read regulation and sign a statement of understanding and forward proof to LPA by POC due date.

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. conducted an unannounced case management visit in conjunction with complaint visit 22-AS-20240725145144. LPA was greeted and granted entry into the facility by Caregiver Maria Carmen Zuniga and explained the reason for the visit. Administrator (AD) Joselolito Soliven arrived shortly after. During the course of the complaint investigation, LPA reviewed documents including the Licensing Information System (LIS) Facility Personnel Report Summary dated July 31, 2024. Per LIS Facility Personnel Report Summary S1 is not associated and/or cleared to work at the facility. Licensee agrees to read the following regulation 87355(e)(1) Criminal Record Clearance and sign a statement of understanding and forward proof to LPA by 08/02/24. Licensee to verify staff is associated and cleared on Guardian prior to their first day working, residing or volunteering at the facility. A $500 Civil Penalty was issued. Based on today's visit, a deficiency is being cited per Title 22 Division 6 of the California Code of Regulations. This report was discussed with AD and a copy was provided as well as Appeal Rights.the state’s words, verbatim · CDSS document, Aug 1, 2024

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87355(e)(1) · Plan of correction due date: Aug 2, 2024

87355 Criminal Record Clearance (e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility: (1) Obtain a California clearance or a criminal record exemption as required by the Department. This requirement is not met as evidence by: Per LIS Facility Personnel Report Summary S1 is not associated and/or cleared to work, reside or volunteer at the facility.the state’s words, verbatim · CDSS document, Aug 1, 2024

Plan of correction: Administrator agrees to obtain a background clearance for S1 to work at the facility. Licensee agress to sent S1 to go get background clearance today. Licensee to provide proof of POC via email by POC due date.