St Anthony's Care Home II

Type of visit: Required - 1 Year

On 10/01/2025 at 11:00 AM, Licensing Program Analyst LPA) Jose Calderon conducted an unannounced annual inspection visit at the St. Anthony’s Care Home II Facility. LPA Calderon was allowed entry into the facility by Administrator Kenneth Soleta. The facility is licensed to operate for six (6) non-ambulatory residents aged 60 and above. Currently, there are six (6) residents residing in the facility, between the age of 60 and above. LPA Calderon explained to Administrator Kenneth Soleta, the purpose of the one-year Annual Inspection visit, and escorted LPA Calderon on a tour of the entire inside and outside facility grounds. As part of the inspection, LPA Calderon reviewed: Six (6) client service records, six (6) client medication records (MAR), four (4) staff records, and inspected the inside facility and outside grounds. The facilities’ last fire drill was conducted on 09/03/2025. The one-story residential home consists of six (6) client bedrooms, three (3) client bathrooms, living room, dining room, kitchen, staff room, office area, attached garage with washer and dryer/ storage area, backyard with table and chairs. No weapons are stored or found on the premise grounds. Kitchen was inspected and observed to be clean and operational. A two-day supply perishable and seven-day supply of non-perishable foods are present in the facility. Emergency Water Storage is in the staff room area. LPA Calderon observed that all facility rooms are clean and in good repair. A comfortable temperature was observed, and the facility has central air and heating. LPA Calderon observed the following during inspection of client’s rooms: mattresses are in good condition, adequate lighting present, plenty of dresser/closet space is present, and all bed linens present. All bedrooms contain furniture, lighting fixtures and personal storage space as required, all beds have the required amount of linen and mattress covers, LPA Calderon observed fully stocked closet with bedding, towels, and toiletries supplies. Bathroom fixtures are clean, in good repair, and working properly and contain the required nonskid mats and grab bars. LPA Calderon observed bathrooms were found to be within Title 22 regulation. Bathroom #1 hot water temperature properly measured at 115 degrees Fahrenheit, bathroom #2 hot water temperature properly measured at 115 degrees Fahrenheit, and bathroom #3 hot water temperature properly measured at 115 degrees Fahrenheit. Kitchen hot water temperature properly measured at 120 degrees Fahrenheit. Facility ten (10), Carbon Monoxide and ten (10) Smoke Detectors were hard-wired and connected were tested and are working properly. Facility two (2) Fire Extinguisher was checked and found to be fully charged and accessible. All exit doors in the facility have alarm systems. The facility has a working landline telephone. All toxins and knives are locked/secured and inaccessible to clients. Medications are centrally stored and in a locked storage cabinet. Facility one (1) first aid kit are fully stocked with manual being checked and in order. Outside grounds were toured and no bodies of water were observed. All Exits/ Walkways around the home were free of debris and hazards. Outside patio accessible to clients. Six (6) client files were reviewed and found to be complete. LPA Calderon reviewed six (6) resident medications (MAR) and they were all found to be administered according to doctor's orders. four (4) staff files were checked and have the required documents. LPA Calderon noted the Administrator Beulah Soleta Certification # 7035960740 expiration date of 04/01/2026 was valid at time of inspection. Commercial General Liability Policy #PCI4419729704 policy period from 07/13/2025 to 07/13/2026 underwritten by Primary Care Insurance Company, coverage 1,000,000/3,000,000 is valid at time of inspection. All the required documents are posted in the facility in a clearly visible area. According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA Calderon did not observe deficiencies therefore no citations were issued at this time. Annual Licensing Fee is CURRENT. An exit interview was conducted, and a copy of the Facility Evaluation Report was provided to Administrator Kenneth Soleta.the state’s words, verbatim · CDSS document, Oct 1, 2025

Allegation investigated: Staff threatened resident Staff do not treat resident with respect Staff harass resident

This report supersedes the report dated 02/12/2025. The investigation findings remain Unsubstantiated. The Purpose of the amendment is to clarify the details of the investigation. On 02/12/2025 Licensing Program Analyst (LPA) Jose Calderon and Jose Anguiano conducted an unannounced visit to the facility St. Anthonys Care Home #2 and was greeted by Administrator Beulah Soleta (S1). LPAs explained the purpose of this visit is to deliver the findings pertaining to the above-mentioned allegations. Investigation consisted of the following: LPA’s interviewed Administrator Beulah Soleta S1, staff S1-S3, resident R1-R6. LPAs obtained and reviewed copies of the following records: Physician Report (dated 12/04/2024), Needs and Service Plan (dated 12/10/2024), Lomita Hospital record (dated 11/29/2024) for R1. The investigation revealed the following: Unsubstantiated Regarding Allegation: Staff threatened resident. It is being alleged that staff threatened not to provide showers to residents and evict residents. During the investigation LPAs toured the facility and noted no negative interactions between staff and residents. Records review indicate the following: Physician Report (dated 12/04/2024) indicates that R1’s other condition includes anxiety. Needs and Service Plan (dated 12/10/2024) indicates the facility developed a plan to address R1’s feelings of anxiety, depression and confusion by assisting R1 on areas of confusion and forgetfulness. Interviews indicate the following: Staff S1- S3 denied the allegation. Resident R1 agreed with the allegation. Resident R2-R6 could not answer interview questions due to health issues. Based on interviews, observations, and supporting documentation, the preponderance of evidence standard has not been met. The allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. therefore, the allegations of “staff threatened resident” is found to be UNSUBSTANTIATED. Regarding Allegation: Staff did not treat resident with respect. During the investigation LPAs toured the facility and noted no negative interactions between staff and residents. Records review indicate the following: Physician Report (dated 12/04/2024) indicates that R1’s other condition includes anxiety. Needs and Service Plan (dated 12/10/2024) indicates the facility developed a plan to address R1’s feelings of anxiety, depression and confusion by assisting R1 on areas of confusion and forgetfulness. Interviews indicate the following: Staff S1- S3 denied the allegation. Resident R1 agreed with the allegation. Resident R2-R6 could not answer interview questions due to health issues. Based on interviews, observations, and supporting documentation, the preponderance of evidence standard has not been met. The allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. therefore, the allegations of “staff did not treat resident with respect” is found to be UNSUBSTANTIATED. Regarding Allegation: Staff harass resident. This complaint alleged that staff harassed R1. During the investigation LPAs toured the facility and noted no negative interactions between staff and residents. Records review indicate the following: Physician Report (dated 12/04/2024) indicates that R1’s other condition includes anxiety. Needs and Service Plan (dated 12/10/2024) indicates the facility developed a plan to address R1’s feelings of anxiety, depression and confusion by assisting R1 on areas of confusion and forgetfulness. Interviews indicate the following: Staff S1- S3 denied the allegation. Resident R1 agreed with the allegation. Resident R2-R6 could not answer interview questions due to health issues. Based on interviews, observations, and supporting documentation, the preponderance of evidence standard has not been met. The allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. therefore, the allegations of “staff harass resident” is found to be UNSUBSTANTIATED. No deficiencies were cited. An exited interview was conducted and a copy of this report was provided to Administrator Beulah Soleta (S1)the state’s words, verbatim · CDSS document, Feb 12, 2025 · control 11-AS-20250206142847

Type of visit: Required - 1 Year

On 10/03/2024 at 08:00 AM, Licensing Program Analyst LPA) Jose Calderon conducted an unannounced annual inspection visit at the St. Anthony’s Care Home II Facility. LPA Calderon was allowed entry into the facility by Administrator Kenneth Soleta. Administrator Kenneth Soleta asked infection control questions and took LPA Calderon temperature prior to entering the facility. The facility is licensed to operate for six (6) non-ambulatory residents ages 60 and above. Currently, there are four (4) residents residing in the facility, between the age of 60 and above. LPA Calderon explained to Administrator Kenneth Soleta, the purpose of the one-year Annual Inspection visit, and escorted LPA Calderon on a tour of the entire inside and outside facility grounds. As part of the inspection, LPA Calderon reviewed: Four (4) client service records, four (4) client medication records (MAR), four (4) staff records, and inspected the inside facility and outside grounds. LPA Calderon interviewed four (4) clients and four (4) staff members for visit. The facilities’ last fire drill was conducted on 09/03/2024. The one-story residential home consists of six (6) client bedrooms, three (3) client bathrooms, living room, dining room, kitchen, staff room, office area, attached garage with washer and dryer/ storage area, backyard with table and chairs. No weapons are stored or found on the premise grounds. Kitchen was inspected and observed to be clean and operational. A two-day supply perishable and seven-day supply of non-perishable foods are present in the facility. Emergency Water Storage is in the staff room area. During the visit, LPA observed the facility infection control practices. LPA observed screening protocols for visitors, staff, and clients, sanitizing stations (Located in common areas and restrooms). LPA observed staff and clients were NOT wearing face coverings. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). LPA Calderon advised the Administrator Kenneth Soleta to continuously monitor the Centers for Disease Control (CDC) website and Community Care Licensing Provider Informational Notices (PIN) for any updates relating to COVID-19 guidance. According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA Calderon did not observe deficiencies therefore no citations were issued at this time. Annual Licensing Fee is CURRENT. An exit interview was conducted, and a copy of the Facility Evaluation Report was provided to Administrator Kenneth Soleta. LPA Calderon observed that all facility rooms are clean and in good repair. A comfortable temperature was observed, and the facility has central air and heating. LPA Calderon observed the following during inspection of client’s rooms: mattresses are in good condition, adequate lighting present, plenty of dresser/closet space is present, and all bed linens present. All bedrooms contain furniture, lighting fixtures and personal storage space as required, all beds have the required amount of linen and mattress covers, LPA Calderon observed fully stocked closet with bedding, towels, and toiletries supplies. Bathroom fixtures are clean, in good repair, and working properly and contain the required nonskid mats and grab bars. LPA Calderon observed bathrooms were found to be within Title 22 regulation. Bathroom #1 hot water temperature properly measured at 117 degrees Fahrenheit, bathroom #2 hot water temperature properly measured at 115 degrees Fahrenheit, and bathroom #3 hot water temperature properly measured at 113 degrees Fahrenheit. Kitchen hot water temperature properly measured at 117 degrees Fahrenheit. Facility ten (10) Carbon Monoxide and ten (10) Smoke Detectors hard wired and connected were tested and are working properly. The facility two (2) Fire Extinguisher was checked and found to be fully charged and accessible. All exit doors in the facility have alarm systems. The facility has a working landline telephone. All toxins and knifes are locked/secured and inaccessible to clients. Medications are centrally stored and in a locked storage cabinet. Facility three (3) first aid kits is fully stocked with manuals was checked and in order. Outside grounds were toured and no bodies of water were observed. All Exits/ Walkways around the home were free of debris and hazards. Outside patio accessible to clients. Four (4) client files were reviewed and found to be complete. LPA Calderon reviewed four (4) resident medications (MAR) and they were all found to be administered according to doctor's orders. four (4) staff files were checked and have the required documents. LPA Calderon noted the Administrator Kenneth Soleta Certification # 7010689740 expiration date of 08/26/2025 was valid at time of inspection. The facility does not handle client's money/cash resources and no Surety bond is needed. Commercial General Liability Policy #PCI4419729704 policy period from 07/13/2024 to 07/13/2025 underwritten by Primary Care Insurance Company, coverage 1,000,000/3,000,000 is valid at time of inspection. Administrator Kenneth Soleta to email LPA Calderon a full copy of the commercial insurance policy including all endorsements no later than 10/15/2024. All the required documents are posted in the facility in a clearly visible area.the state’s words, verbatim · CDSS document, Oct 3, 2024

Type of visit: Required - 1 Year

On 10/27/2023, Licensing Program Analyst (LPA) Lourdes Montoya conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with House Manager Myrna Dennis and explained the purpose of the visit. At around 11:15 AM, Administrator Beulah Soleta arrived and joined the visit. The facility is licensed to operate for six (6) non-ambulatory elderly residents ages 60 and above. The facility is approved for two (2) hospice residents. The facility is a single-story structure located in a residential neighborhood. The facility consists of the following: six (6) resident's bedrooms, two (2) resident bathrooms, two (2) staff bedrooms, one (1) staff bathroom, a living room area, dining area, and kitchen. The washer and dryer are located next to one of the staff bedrooms. There is a shaded patio area with ample seating area for the residents. The facility does not handle residents’ cash resources. Facility Annual Fees are current during today’s visit. Administrator's certificate expires 4/1/2024. At around 11:00 AM, LPA toured the inside and outside grounds of the facility with House Manager Myrna Dennis. Carbon monoxide and smoke detectors were tested and found to be operable. The last facility fire drill was on August 8, 2023. LPA observed the facility to be sanitary and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, and toxins were stored and not accessible to clients. The kitchen was inspected and there are sufficient two-day perishable and seven-day non-perishable food supplies. There are no pools or bodies of water on the premises. There are no firearms on the premises or other dangerous weapons. Centrally stored medications are locked in a cabinet located in the medication room. The first aid kit has all required supplies. The facility has a written emergency disaster plan posted in the living room. The facility is maintained at a comfortable temperature. There are working lights or lamps in each room at the time of visit. There are grab bars for each toilet and shower used by residents. Showers have non-skid floors. Report Continued in LIC 809-C LPA observed the following deficiencies: 1. One resident (R3) is bedridden according to Physician's Report. 2. The hot water temperature in the residents' common bathroom was 146.0 degrees Fahrenheit. 3. Three residents don't have current Appraisal/Needs and Services Plan. 4. Two staff don't have health screening records/TB test records. 5. Three residents don't have TB test records. 6. Fire extinguishers were last serviced on 9/14/202. Further inspection is needed. LPA will return to conduct additional inspection and to issue additional citations. Some of the above deficiencies are being cited based on LPA observations, interviews conducted and records review in accordance with the California Code of Regulations, Title 22, see LIC809D. Civil penalty is being assessed. An exit interview was conducted, Plans of Corrections were reviewed and developed. A copy of this report and appeal rights were discussed and left wit Administrator Beulah Soleta.the state’s words, verbatim · CDSS document, Oct 27, 2023