Genesis Manor

Type of visit: Required - 1 Year

On September 14, 2026 at 12:40 PM Licensing Program Analysts (LPAs) LaVette Farlow and Renese Howell-Small made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA met with Facility Caregiver Gerardo Alfonso and was granted entry to the facility. Gerardo notified the Administrator Alaina Hendrick of LPA's arrival. At the time of the visit there were two (2) staff and six (6) residents present. The facility is a two story six (6) bedroom, five (5), bathroom home for residents and the second story room is for staff, with a kitchen/dining area, living room, and attached garage. The facility is a Residential Care Facility for Elderly (RCFE) Licensed capacity is (6) current census (6). LPAs was accompanied by Facility Caregiver, Gerardo and Administrator, Alaina to conduct a general overall inspection, which included, but was not limited to, the following: Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature 77 degrees Fahrenheit. LPA inspected resident bedrooms; they are equipped with required furniture such as: mattresses, night stands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA observed sufficient furniture and lighting throughout the facility. LPA measured and observed the water temperatures in the bathrooms to be 107.7, 106.9 and 107.9, degrees Fahrenheit. The facility is equipped with operating smoke detectors and carbon monoxide alarms. Posters such as personal rights, the CCL complaint poster, and the disaster plan were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to residents in care. There was a designated storage space for resident/staff files. Medications are kept inside medication closet inaccessible to residents in care. Overall, the facility is clean, in good repair, and operating in safe conditions for residents in care. Food Service: Non-perishable and perishable food supply is sufficient for number of residents in care. LPA observed emergency food supply and water for residents and staff. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. All staff members working in the facility have criminal record clearance through the Department. Record Review: LPAs reviewed three (3) resident files for admission agreements, updated physician reports and TB test results, and needs and services plans. LPAs observed that residents files appeared to be maintained. LPA also reviewed three (3) staff files for First Aid/CPR certification, criminal record clearance, training, and health screenings with TB test results. LPAs observed staff file were maintained. Medications were audited at random. LPAs reviewed three (3) residents MARs and Centrally Store Medication log. One (1) out of Three (3) residents centrally stored medication were incomplete. The centrally stored medication log sheet for R1 was missing the medication Lorazepam with a refill date of 9/8/2026. Based on LPA's observation the medication is currently being dispensed. A Deficiency cited. LPAs reviewed facility records for Liability Insurance, Emergency Disaster Plan (LIC610E), Infection Control Plan (LIC9282), Fire Drills, and Complaint Poster/Ombudsman Poster. LPAs observed the facility was conducting fire drills, but not at various times to cover the evening or NOC shift. A Technical Assistance issued. Based on the observations made during today’s visit, one (1) deficiency was cited and one (1) technical assistance was issued, per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809), (LIC809C), (LIC809D), (LIC9102TA) and appeal rights were discussed and copies were provided to the Facility Administrator, Alaina Hendrick.the state’s words, verbatim · CDSS document, Sep 14, 2026

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87465(h)(6) · Plan of correction due date: Sep 25, 2026

87465(h)...requirements...are centrally stored:(6)... licensee shall be responsible for assuring that a record of centrally stored prescription medications for each resident is maintained... This requirement is not met as evidenced by: Based on observation, and record review, the licensee did not comply with the section cited above not ensuring that R1 centrally stored medication log was maintained by listing all of R1 medication that was currently being dispense and the bubble pack was issued on 9/8/2026, which posed a potential health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Sep 14, 2026

Plan of correction: Licensee agreed to conduct a training regarding centrally stored medication and logging procedures, review the regulation cited and submit a statement of understanding to LPA by POC due date.

Type of visit: Required - 1 Year

On November 12, 2025 at 9:45 AM Licensing Program Analyst (LPA) LaVette Farlow made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA met with Facility Caregiver Gerardo Alfonso and was granted entry to the facility. Gerardo notified the Administrator Alaina Hendrick of LPA's arrival. At the time of the visit there was two (2) staff present, and five (5) residents present. The facility is a two story six (6) bedroom, five (5), bathroom are for residents and the second story room is for staff, with a kitchen/dining area, living room, and attached garage. The facility is a Residential Care Facility for Elderly (RCFE) Licensed capacity is (6) current census (5). LPA was accompanied by Facility Caregiver, Gerardo and Administrator, Alaina to conduct a general overall inspection, which included, but was not limited to, the following: Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature 72 degrees Fahrenheit. LPA inspected resident’s bedrooms; they are equipped with required furniture such as: mattresses, night stands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA observed the hallway bathroom was missing it's door. Caregiver and Administrator informed LPA that the door was removed due to lock repair and a hole in the door. Administrator stated the repairs should be completed within the next 48 hours. A technical advisory noted. LPA observed sufficient furniture and lighting throughout the facility. LPA measured and observed the water temperatures in the bathrooms/kitchen to be 110.6 and 111.2, degrees Fahrenheit. The facility is equipped with operating smoke detectors and carbon monoxide alarms. Posters such as personal rights, the CCL complaint poster, and the disaster plan were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to residents in care. There was a designated storage space for resident/staff files. Medications are kept inside medication closet inaccessible to residents in care. Overall, the facility is clean, in good repair, and operating in safe conditions for residents in care. Food Service: Non-perishable and perishable food supply is sufficient for number of residents in care. LPA observed emergency food supply and water for residents and staff. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. All staff members working in the facility have criminal record clearance through the department. Record Review: LPA reviewed three (3) resident files for admission agreements, updated physician reports, and needs and services plans. LPA observed that three (3) out of three (3) residents file were missing a annual Needs and Service Plan. A deficiency cited. LPA also reviewed three (3) staff files for First Aid/CPR certification, criminal record clearance, training, and health screenings. LPA observed staff file were maintained. Medications were audited at random. LPA reviewed three (3) residents medication log. Two (2) out of three (3) residents centrally stored medication were incomplete. The centrally stored medication log for the month of November was missing medication that was issued in January, August, and October and the facility was not maintaining a MARS log for PRN medications. Deficiencies cited. Based on the observations made during today’s visit, two (2) deficiency were cite and one (1) technical advisory was issued, per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809), (LIC809C), (LIC809D) and appeal rights was discussed and provided to Facility Administrator Alaina Hendrick.the state’s words, verbatim · CDSS document, Nov 12, 2025

The state marks this report as 6 pages; the online copy we transcribed has 5. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) LaVette Farlow made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA met with Facility Caregiver Gerardo Alfonso and was granted entry to the facility. At the time of the visit there was two (2) staff present, and five (5) residents present. The facility is a six (6) bedroom, four (4), bathroom home, with a kitchen/dining area, living room, and attached garage. The facility is a Residential Care Facility for Elderly (RCFE) Licensed capacity is (6) current census (5). LPA was accompanied by Facility Caregiver, to conduct a general overall inspection, which included, but was not limited to, the following: Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature 77 degrees Fahrenheit. LPA inspected resident’s bedrooms; they are equipped with required furniture such as: mattresses, night stands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA observed sufficient furniture and lighting throughout the facility. LPA measured and observed the water temperatures in the bathrooms/kitchen to be 116.2, 115.2, and 116.2, degrees Fahrenheit. The facility is equipped with operating smoke detectors and carbon monoxide alarms. Posters such as personal rights, the CCL complaint poster, and the disaster plan were posted in a common area. LPA observed the Administrator did not complete an annual review of the Emergency and Disaster Plan as required. Technical violation issued. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to residents in care. There was a designated storage space for resident/staff files. Medications are kept inside medication closet inaccessible to residents in care. Overall, the facility is clean, in good repair, and operating in safe conditions for residents in care. Food Service: Non-perishable and perishable food supply is sufficient for number of residents in care. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. All staff members working in the facility have criminal record clearance through the department. Record Review: LPA reviewed three (3) resident files for admission agreements, updated physician reports, and needs and services plans. LPA also reviewed three (3) staff files for First Aid/CPR certification, criminal record clearance, training, and health screenings. LPA observed staff file were not maintain with training or current CPR records. Technical violation issued. Medications were audited at random. LPA observed two (2) out of two (2) residents medication log was not maintain according to the prescribing physician orders. LPA observed medication listed that were not available according to the physician orders. Technical violation issued. Based on the observations made during today’s visit, three (3) technical violation were issued, and no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809), (LIC809C) and (9102TV) was discussed and provided to Facility Administrator Marya Alpert.the state’s words, verbatim · CDSS document, Nov 25, 2024

The state marks this report as 5 pages; the online copy we transcribed has 2. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Paola Guerrero made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA met with Facility Caregiver Gerardo Alfonso and was granted entry to the facility. At the time of the visit there was two (2) staff present, and four (4) residents present. The facility is a six (6) bedroom, four (4), bathroom home, with a kitchen/dining area, living room, and attached garage. The facility is a Residential Care Facility for Elderly (RCFE) Licensed capacity is (6) current census (4). LPA was accompanied by Facility Caregiver, to conduct a general overall inspection, which included, but was not limited to, the following: Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature. LPA inspected resident’s bedrooms; they are equipped with required furniture such as: mattresses, nightstands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA observed sufficient furniture and lighting throughout the facility. LPA measured and observed the water temperatures in the bathrooms to be 109.6 degrees F The facility is equipped with operating smoke detectors and carbon monoxide alarms. Posters such as personal rights, the CCL complaint poster, and the disaster plan were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to residents in care. There was a designated storage space for resident/staff files. Medications are kept inside medication closet inaccessible to residents in care. Overall, the facility is clean, in good repair, and operating in safe conditions for residents in care. Food Service: Non-perishable and perishable food supply is sufficient for number of residents in care. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. All staff members working in the facility have criminal record clearance through the department. Record Review: LPA reviewed four (4) resident files for admission agreements, updated physician reports, and needs and services plans. LPA also reviewed three (3) staff files for First Aid/CPR certification, criminal record clearance, training, and health screenings. Medications were audited at random and appeared to be dispensed appropriately by staff members. Based on the observations made during today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809) was discussed and provided to Facility Caregiver Gerardo Alfonso.the state’s words, verbatim · CDSS document, Dec 11, 2023