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
NameTitleContext
David MarkieAdministratorMet with Licensing Program Analyst during inspection and named in report
Mary RicoLicensing Program AnalystConducted the inspection visit
Efren MalagonLicensing Program ManagerNamed in report as Licensing Program Manager
Marietta TecsonCaregiverAccompanied 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
NameTitleContext
Amber ColemanLicensing Program AnalystConducted the annual inspection
David MarkieAdministratorFacility administrator mentioned during the inspection
Marietta TecsonCaregiverGreeted the Licensing Program Analyst upon arrival
AlfonsaStaff 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
NameTitleContext
Amber ColemanLicensing Program AnalystConducted the visit, obtained signatures, and completed the report.
David MarkieAdministratorFacility administrator mentioned in the report.
Marrietta TecsonCaregiverMet with the Licensing Program Analyst during the visit.
Nedra BrownLicensing Program ManagerNamed 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
NameTitleContext
Amber ColemanLicensing Program AnalystConducted the complaint investigation and delivered findings
David MarkieAdministratorFacility Administrator mentioned in the report
Marrietta TecsonCaregiverMet with Licensing Program Analyst and granted entry to the facility
Nedra BrownLicensing Program ManagerNamed 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)
DescriptionSeverity
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
NameTitleContext
Rohit LamaLicensing Program AnalystConducted the complaint investigation and exit interview
Nedra BrownLicensing Program ManagerNamed in report as Licensing Program Manager
David MarkieAdministratorFacility administrator named in report
Marya AlpertAdministratorAdministrator 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
NameTitleContext
Josephine SandigancaregiverMet with Licensing Program Analyst during inspection and discussed report findings.
Shaunte HenryLicensing Program AnalystConducted the unannounced annual inspection.
Nedra BrownLicensing Program ManagerNamed in the report as Licensing Program Manager.

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