Inspection Reports for Genesis Manor IV
1691 Genesee Ave, La Verne, CA 91750, CA, 91750
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Inspection Report
Annual Inspection
Census: 6
Capacity: 6
Deficiencies: 0
Mar 17, 2025
Visit Reason
An unannounced annual inspection visit was conducted to evaluate compliance with regulatory requirements and assess the facility's environment, safety, staffing, and resident care.
Findings
The inspection found the facility to be in compliance with all regulatory requirements. Safety measures, medication storage, staffing qualifications, infection control, and resident records were all satisfactory. No deficiencies were observed during the visit.
Report Facts
Residents on hospice care: 3
Personnel records reviewed: 3
Resident records reviewed: 6
Fire clearance capacity: 6
Facility capacity: 6
Current census: 6
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Kimberly Ramirez | Licensing Program Analyst | Conducted the unannounced annual inspection visit. |
| Elyssa Markie | Administrator | Facility administrator present during inspection. |
| Tony Vasallo | Supervisor | Supervisor named in the report. |
Inspection Report
Annual Inspection
Census: 4
Capacity: 6
Deficiencies: 0
Mar 22, 2024
Visit Reason
The inspection was an unannounced subsequent Annual Required Visit conducted to evaluate compliance with licensing requirements for the facility.
Findings
No deficiencies were observed during the inspection. The facility was found to have current liability insurance, an updated infection control plan, operable fire and carbon monoxide detectors, and properly maintained personnel and resident records.
Report Facts
Fire drills conducted: 2
Staff files reviewed: 3
Resident files reviewed: 4
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Kimberly Ramirez | Licensing Program Analyst | Conducted the inspection and evaluation |
| Alaina Hendrick | Back-up Administrator | Assisted with the inspection |
| Gerry A. Markie | Administrator | Facility Administrator named in report |
Inspection Report
Annual Inspection
Census: 4
Capacity: 6
Deficiencies: 0
Mar 18, 2024
Visit Reason
An unannounced Annual Required Visit was conducted to evaluate the facility's compliance with licensing requirements for elderly care, including dementia and hospice residents.
Findings
The facility was observed to be clean and well-maintained with no deficiencies noted at the time of the visit. The kitchen, dining, living areas, resident rooms, and other facility areas met required standards.
Report Facts
Licensed hospice residents allowed: 3
Kitchen sink water temperature: 110.1
Number of bedrooms: 5
Number of bathrooms: 2
Number of chairs in dining room: 5
Number of couches in living room: 2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Kimberly Ramirez | Licensing Program Analyst | Conducted the unannounced annual inspection visit |
| Natividad Almodovar | Caregiver | Met with Licensing Program Analyst during the visit |
Inspection Report
Complaint Investigation
Census: 6
Capacity: 6
Deficiencies: 0
Oct 10, 2023
Visit Reason
An unannounced complaint investigation visit was conducted to investigate allegations including staff preventing home health agency staff from performing their duties, uncleared staff working in the facility, and the facility lacking a qualified administrator.
Findings
The investigation found no preponderance of evidence to substantiate the allegations. Staff and residents denied the allegations, records showed appropriate staff clearance and association, and the facility had a qualified administrator. No deficiencies were observed or cited.
Complaint Details
The complaint investigation was unsubstantiated. Allegations included staff preventing home health agency staff from performing duties, uncleared staff working in the facility, and lack of a qualified administrator. Interviews and records review did not support these allegations.
Report Facts
Residents receiving home health care: 2
Staff interviewed: 5
Residents interviewed: 6
Facility capacity: 6
Facility census: 6
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Gerry A. Markie | Administrator | Facility administrator met during investigation |
| Valeria Maldonado | Licensing Program Analyst | Conducted the complaint investigation visit |
| Fernando Fierros | Licensing Program Manager | Named as Licensing Program Manager on report |
| Elyssa Markie | Administrator | Listed as qualified administrator with certificate |
Inspection Report
Annual Inspection
Census: 5
Capacity: 6
Deficiencies: 0
Feb 4, 2023
Visit Reason
An unannounced annual required visit was conducted to evaluate the facility's compliance with licensing requirements for elderly residents with dementia, including care for hospice residents.
Findings
The facility was found to be clean, well-maintained, and in compliance with regulations. No deficiencies were cited during the visit. Safety measures such as secured medications, proper water temperatures, and emergency supplies were observed.
Report Facts
Licensed capacity: 6
Current census: 5
Water temperature: 119.8
Water temperature: 105.1
Water temperature: 105.4
Days of perishables: 2
Days of non-perishables: 7
Medications reviewed: 5
Hospice residents allowed: 3
Hospice residents present: 0
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Gerry A. Markie | Administrator | Facility administrator who led the tour and was present during exit interview |
| Kimberly Ramirez | Licensing Program Analyst | Conducted the unannounced annual required visit |
| Tony Vasallo | Supervisor | Supervisor overseeing the licensing evaluation |
| Natividad Almodovar | Caregiver | Met the Licensing Program Analyst at the start of the visit |
Inspection Report
Annual Inspection
Census: 6
Capacity: 6
Deficiencies: 0
Feb 24, 2022
Visit Reason
Licensing Program Analyst conducted an annual required visit to evaluate the facility, including infection control, physical plant, medications, food supply, and staff records.
Findings
No deficiencies were observed during the visit. The facility met all regulatory requirements including infection control, medication storage, and physical environment standards.
Report Facts
Residents on hospice: 1
Resident records reviewed: 6
Staff records reviewed: 2
Residents' medications reviewed: 6
Hot water temperature: 106.6
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Gerry A. Markie | Administrator | Met with Licensing Program Analyst during the inspection |
| Elyssa Markie | Staff member | Met with Licensing Program Analyst during the inspection |
| Tony Vasallo | Licensing Program Analyst | Conducted the annual required visit |
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