St. Therese Care Home

Type of visit: Required - 1 Year

Licensing Program Analysts (LPAs) Sarina Ramirez and Eldin Serrano made an unannounced visit to the facility to conduct a required annual inspection. LPAs met with House Manager Rico Paguio, and discussed the purpose of the visit. The facility is a Residential Care Facility for the Elderly (RCFE) with a license capacity of (20), a current census of (11). LPAs conducted an overall inspection of the facility, which included, but was not limited to, the following: Physical Plant/Environment: Indoor and outdoor passageways are free of obstruction.The facility does not have a swimming pool or similar bodies of water. The facility is enclosed and gated, however both sides remain locked, deficiency issued. The facility has sufficient lighting and is maintained at a comfortable temperature at 73 degrees F. The facility has sufficient indoor and outdoor space for resident activities. The facility is equipped with operating smoke detectors/carbon monoxide alarms last checked by Pro Security Systems on 01/15/26, working laundry equipment, and telephone service. Resident’s showers, toilets, and hand washing areas were operating properly. The hot water temperature in three (3) bathrooms measured between 105.4 and 113 degrees F. Seven (7) resident’s bedrooms had beds, bed linen, chairs, dresser, storage space and sufficient lighting. The facility has sufficient linens, towels, and personal hygiene items for residents. The facility has posted in a common area, facility license, administrator certificate, facility sketch, emergency telephone numbers, monthly menu, monthly activities, personal rights, Admissions Agreement, CCLD complaint poster, and Ombudsman poster. Continuation on LIC – 809C: Food Service: Facility kitchen and dining area are maintained clean. The facility has sufficient non-perishable and perishable food supply for residents in care, however the facility does not have emergency food supply, deficiency issued. Chemicals were kept locked and inaccessible to residents in care, however the sharps were not locked, deficiency issued. Care & Supervision: Facility has 24-hour/7days a week care staff. Medical Related Services: Resident’s medications are labeled and centrally stored in a locked cabinet. Four (4) residents medications were audited at random, R1's medication was being signed off as given, however the medication was not taken by R1, deficiency issued. Record Review: Five (5) Staff files reviewed were observed to be incomplete, Administrator's file was incomplete; deficiency issued. Four (4) Resident files reviewed were observed to be complete. Based on observations and record review technical assistance/violations and deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report along with LIC 809D, LIC 9102, and Appeal Rights were discussed and provided to House Manager Rico Paguio at the conclusion of the visit.the state’s words, verbatim · CDSS document, Jan 26, 2026

The state marks this report as 9 pages; the online copy we transcribed has 8. You can request the full file from the county licensing office.

Allegation investigated: Facility staff handled a resident in a rough manner Facility staff spoke inappropriately to residents Facility staff did not ensure facility was maintained clean

Licensing Program Analysts (LPAs) Sarina Ramirez and Eldin Serrano conducted an unannounced visit to the facility to conduct a complaint investigation on the above allegations. LPAs met with Administrator Eli Catacutan, and discussed the purpose of the visit. Regarding Allegation #1, LPAs interviewed four (4) staff; all 4 staff have denied handling residents in a rough manner nor have they witnessed other staff handle residents in a rough manner. LPAs interviewed six (6) out of nine (9) residents, two (2) residents were sleeping and one (1) is non verbal. All 6 residents have informed LPAs staff do not handle residents in a rough manner, they are all treated nicely, respectfully, and professionally. Regarding Allegation #2, LPAs interviewed four (4) staff; all 4 staff have denied speaking inappropriately to residents. LPAs interviewed 6 residents, all 6 have stated staff do not speak to them inappropriately nor have they seen or heard of staff speaking to fellow residents inappropriately. Regarding Allegation #3, LPAs toured the facility and observed the facility to be clean and passageways are free of obstruction. Based on LPAs observations, record review, and interviews, the above allegations are Unsubstantiated; meaning that although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. An exit interview was conducted where this report was discussed and a copy was provided to Administrator Eli Catacutan at the conclusion of the visit. Unsubstantiatedthe state’s words, verbatim · CDSS document, Sep 16, 2025 · control 56-AS-20250912084123

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sarina Ramirez made an unannounced visit to the facility to conduct a required annual inspection. LPA met with House Manager Rico Paguio, and discussed the purpose of the visit. The facility is a Residential Care Facility for the Elderly (RCFE) with a license capacity of (20), a current census of (9). LPA conducted an overall inspection of the facility, which included, but was not limited to, the following: Physical Plant/Environment: Indoor and outdoor passageways are free of obstruction. The facility does not have a swimming pool or similar bodies of water. The facility has sufficient lighting and is maintained at a comfortable temperature. The facility has sufficient indoor and outdoor space for resident activities.The facility is equipped with operating smoke detectors/carbon monoxide alarms last checked by Pro Security Systems on 1/13/25, working laundry equipment, and telephone service. Resident’s showers, toilets, and hand washing areas were operating properly. The hot water temperature in five (5) bathrooms measured between 107 and 111.5 degrees F. Seven (7) resident’s bedrooms had beds, bed linen, chairs, dresser, storage space and sufficient lighting. The facility has sufficient linens, towels, and personal hygiene items for residents. The facility has posted in a common area, facility license, administrator certificate, facility sketch, emergency disaster plan and telephone numbers, monthly menu, monthly activities, personal rights, Admissions Agreement, CCLD complaint poster, and Ombudsman poster. Food Service: Facility kitchen and dining area are maintained clean. The facility has sufficient non-perishable and perishable food supply for residents in care. Sharps and chemicals were kept locked and inaccessible to residents in care. Continuation on LIC – 809C: Care & Supervision: Facility has 24-hour/7days a week care staff. Medical Related Services: Resident’s medications are labeled and centrally stored in a locked cabinet. Record Review: Five (5) Staff files reviewed were observed to be complete. Four (4) Resident files reviewed were observed to be complete. Based on observations and record review technical assistance/violations were discussed, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report along with LIC 902 were discussed and provided to House Manager Rico Paguio.the state’s words, verbatim · CDSS document, Apr 9, 2025

The state marks this report as 8 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Magda Malcore made an announced visit to the facility to conduct a Prelicensing inspection. LPA met with Eliseo Catacutan, License Applicant. This facility was previously licensed as Crystal Care Villa (366425922) and is undergoing a change of ownership. The pending application is for a Residential Care Facility for the Elderly (RCFE) with a capacity of 20 residents. A fire clearance from the San Bernardino County Fire District was granted on 8/22/2023 for twelve (12) non-ambulatory residents and eight (8) bedridden residents. LPA conducted an overall inspection of the following: Physical plant is consistent with facility sketch submitted with application. Indoor and outdoor passageways are free of obstruction. The facility has no bodies of water. The entire perimeter of the facility is fenced. The facility has sufficient indoor and outdoor activity space for resident activities. The facility has sufficient lighting and is maintained at a comfortable temperature. Resident’s bathrooms are clean and equipped with grab bars. Bathroom equipment are working properly and the hot water temperature in residents' bathrooms measured between 105 and 111 degrees F. Resident’s bedrooms have sufficient bed linen, lighting and furniture in good repair. Facility has operating carbon monoxide alarms, auditory door signals, and telephone service. The facility has sufficient linen, towels, and personal hygiene items for residents. The facility has posted in a common area, resident activities, Community Care Licensing complaint poster, Ombudsman poster, Theft and Loss policy, Resident personal rights, disaster evacuation plan and emergency telephone numbers. The facility has a locked centralized area for residents medications. The facility a confidential storage area for staff and resident files. The facility kitchen and dining areas are maintained clean and odorless. The facility has sufficient non-perishable and perishable food supply for residents. The facility's refrigerators and freezers are operating in a healthful manner. The facility has sufficient cups, plates, and utensils for residents. Sharps, pesticides and other cleaning solutions are kept locked and stored away from food areas. Prelicensing inspection is complete, no corrections are required at this time. COMP III orientation was completed with Eliseo Catacutan during today's visit. An exit interview was conducted and a copy of this report was provided to the Eliseo Catacutan at the conclusion of the visit.the state’s words, verbatim · CDSS document, Jan 26, 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: Office

Facility Type: RCFE Application Type: chow Capacity: 20 Census (if any clients in care): 10 Interview Method: Telephone interview On 1/2/2024, applicant/administrator participated in COMP II. Identification of the applicant / administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant / administrator confirmed that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Admission Policies 3. Staffing requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, Jan 2, 2024