Inspection Reports for Genesis Manor VI
6936 Amethyst Ave, Rancho Cucamonga, CA 91701, CA, 91701
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Inspection Report
Annual Inspection
Census: 3
Capacity: 6
Deficiencies: 0
Feb 26, 2025
Visit Reason
The visit was an unannounced required comprehensive annual inspection conducted by the Licensing Program Analyst Mary Rico to assess compliance with regulations.
Findings
The facility was found to be operating within approved capacity and in safe, clean conditions with sufficient care staff and proper maintenance of physical plant, food service, and records. No deficiencies were cited during the inspection.
Report Facts
Resident files reviewed: 3
Resident medications reviewed: 3
Hospice files reviewed: 1
Staff files reviewed: 4
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| David Markie | Administrator | Met with Licensing Program Analyst during inspection and named in report |
| Mary Rico | Licensing Program Analyst | Conducted the inspection visit |
| Efren Malagon | Licensing Program Manager | Named in report as Licensing Program Manager |
| Marietta Tecson | Caregiver | Accompanied Licensing Program Analyst during inspection |
Inspection Report
Annual Inspection
Census: 6
Capacity: 6
Deficiencies: 0
Jan 22, 2024
Visit Reason
The Licensing Program Analyst conducted an unannounced annual inspection of the Genesis Manor VI facility to evaluate compliance with licensing requirements.
Findings
The facility was found to be clean, in good repair, and operating in safe conditions for residents. No deficiencies were cited during the inspection.
Report Facts
Staff members present: 4
Resident files reviewed: 3
Staff files reviewed: 2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Amber Coleman | Licensing Program Analyst | Conducted the annual inspection |
| David Markie | Administrator | Facility administrator mentioned during the inspection |
| Marietta Tecson | Caregiver | Greeted the Licensing Program Analyst upon arrival |
| Alfonsa | Staff member who contacted the Administrator during the visit |
Inspection Report
Census: 6
Capacity: 6
Deficiencies: 0
Oct 30, 2023
Visit Reason
The visit was conducted to obtain signatures on an Amended Report as part of case management activities.
Findings
The Licensing Program Analyst met with staff, introduced herself, obtained signatures, and completed the report. An exit interview was conducted where the report was discussed and provided to the facility representative.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Amber Coleman | Licensing Program Analyst | Conducted the visit, obtained signatures, and completed the report. |
| David Markie | Administrator | Facility administrator mentioned in the report. |
| Marrietta Tecson | Caregiver | Met with the Licensing Program Analyst during the visit. |
| Nedra Brown | Licensing Program Manager | Named as Licensing Program Manager in the report. |
Inspection Report
Complaint Investigation
Census: 6
Capacity: 6
Deficiencies: 0
Oct 30, 2023
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations that staff prevented home health agency staff from performing their duties, uncleared staff were allowed to work in the facility, and the facility did not have a qualified Administrator.
Findings
The investigation found no substantiated evidence supporting the allegations. Staff files showed proper fingerprint clearances, criminal background checks, and up-to-date training. Administrator certificates were current and in good standing. No deficiencies were cited, and the allegations were determined to be unsubstantiated or unfounded.
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. The findings showed no evidence to support these allegations, and the complaint was dismissed.
Report Facts
Capacity: 6
Census: 6
Staff files reviewed: 4
Administrator Certificates found: 3
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Amber Coleman | Licensing Program Analyst | Conducted the complaint investigation and delivered findings |
| David Markie | Administrator | Facility Administrator mentioned in the report |
| Marrietta Tecson | Caregiver | Met with Licensing Program Analyst and granted entry to the facility |
| Nedra Brown | Licensing Program Manager | Named as Licensing Program Manager overseeing the investigation |
Inspection Report
Complaint Investigation
Census: 6
Capacity: 6
Deficiencies: 1
Apr 27, 2022
Visit Reason
An unannounced complaint investigation was conducted due to allegations of lack of supervision leading to inappropriate resident interaction and failure to provide a safe environment for residents.
Findings
The allegation of lack of supervision resulting in inappropriate behavior between residents was substantiated. However, the allegation that staff failed to provide a safe environment was unsubstantiated based on interviews and observations.
Complaint Details
The complaint was substantiated regarding lack of supervision leading to inappropriate resident interaction. The allegation that staff failed to provide a safe environment was unsubstantiated.
Severity Breakdown
Type B: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Care of Persons with Dementia: Licensees who accept and retain residents with dementia shall ensure adequate direct care staff to support each resident's physical, social, emotional, safety and health care needs. This regulation was not met as evidenced by interviews with staff that residents engaged in inappropriate behavior posing a potential health and safety risk. | Type B |
Report Facts
Civil penalty amount per day per resident: 100
Number of residents: 6
Plan of Correction due date: May 11, 2022
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Rohit Lama | Licensing Program Analyst | Conducted the complaint investigation and exit interview |
| Nedra Brown | Licensing Program Manager | Named in report as Licensing Program Manager |
| David Markie | Administrator | Facility administrator named in report |
| Marya Alpert | Administrator | Administrator met with during investigation and exit interview |
Inspection Report
Annual Inspection
Census: 5
Capacity: 6
Deficiencies: 0
Feb 25, 2022
Visit Reason
The inspection was an unannounced annual inspection with an emphasis on infection control conducted by the Licensing Program Analyst.
Findings
No deficiencies were observed or cited during the visit. The facility demonstrated compliance with infection control practices, including COVID-19 symptom screening, PPE availability, and a COVID mitigation plan.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Josephine Sandigan | caregiver | Met with Licensing Program Analyst during inspection and discussed report findings. |
| Shaunte Henry | Licensing Program Analyst | Conducted the unannounced annual inspection. |
| Nedra Brown | Licensing Program Manager | Named in the report as Licensing Program Manager. |
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