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
NameTitleContext
Kimberly RamirezLicensing Program AnalystConducted the unannounced annual inspection visit.
Elyssa MarkieAdministratorFacility administrator present during inspection.
Tony VasalloSupervisorSupervisor 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
NameTitleContext
Kimberly RamirezLicensing Program AnalystConducted the inspection and evaluation
Alaina HendrickBack-up AdministratorAssisted with the inspection
Gerry A. MarkieAdministratorFacility 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
NameTitleContext
Kimberly RamirezLicensing Program AnalystConducted the unannounced annual inspection visit
Natividad AlmodovarCaregiverMet 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
NameTitleContext
Gerry A. MarkieAdministratorFacility administrator met during investigation
Valeria MaldonadoLicensing Program AnalystConducted the complaint investigation visit
Fernando FierrosLicensing Program ManagerNamed as Licensing Program Manager on report
Elyssa MarkieAdministratorListed 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
NameTitleContext
Gerry A. MarkieAdministratorFacility administrator who led the tour and was present during exit interview
Kimberly RamirezLicensing Program AnalystConducted the unannounced annual required visit
Tony VasalloSupervisorSupervisor overseeing the licensing evaluation
Natividad AlmodovarCaregiverMet 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
NameTitleContext
Gerry A. MarkieAdministratorMet with Licensing Program Analyst during the inspection
Elyssa MarkieStaff memberMet with Licensing Program Analyst during the inspection
Tony VasalloLicensing Program AnalystConducted the annual required visit

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