Genesee Villa

Type of visit: Required - 1 Year

License Program Analysts (LPA) Luis De Leon conducted an unannounced annual required visit. LPA met with Administrator Maria Clark. The purpose of today’s visit was explained. The facility is licensed to serve 5 ambulatory and 1 non-ambulatory elderly residents age 59 and over. There are currently five (5) residents placed at the facility. Residents are serviced by Frank D. Lanterman Regional Center. The LPA use the Compliance & Regulatory Enforcement Tool (CARE) during today’s inspection. The visit consisted as follows: FACILITY PHYSICAL PLANT The facility is in a residential area and is made up of a two-story building with five (5) resident bedrooms, three (3) full bathrooms for residents to use, a living room, a kitchen, laundry room, front and backyard, and a detached car garage. There was no body of water observed in the property. REVIEW OF FILES Resident record review consisted of Admission Agreements, Identification and Emergency Info, Consent Report, Individual Program Plan, and Personal Rights. Resident’s P&I money were reviewed for 5 residents. Staff record review consisted of Personnel Report, Health Screening, Criminal Record Statements, Fingerprint Clearance, Training, First Aid and CPR. Staff S1-S2 did not have a health screening record in facility file. A deficiency is noted on LIC-809D. The facility liability insurance, surety bond, infection control plan and the emergency disaster plan. (Report continues on page LIC-809C...) Observations during facility tour: Bedrooms were furnished with a bedframe, dresser, lamps, and chairs. LPA observed that there were clean linen, bath towels, and personal hygiene with reasonable closet space available for residents. Wall and floors are in good repair. Hallways were clean and free of obstructions. Kitchen appliances were in working order and clean. There is sufficient two (2) days of perishables and seven (7) day supply of non-perishable food. Additional food supply was observed in storage in the rear of the facility. Refrigerator and freezer temperature were in compliance with Title 22 regulation. Toilets, showers, and water faucets are found in compliance with Title 22 regulations for temperature and function. Restrooms were stocked and clean. The water temperature was tested and measured. It was found in compliance with Title 22 regulations between 105º and 120º F degrees. Sharps are locked inside the kitchen drawer and inaccessible to residents. Also, disinfectants and cleaning supplies are locked and secured inaccessible to residents. Smoke detectors were observed in all bedrooms and carbon monoxide detectors was observed in living room around kitchen area. Three (3) fire extinguishers were observed and were fully charged with last inspection on 07/22/2026. Last fire drill and earthquake drill were conducted on 08/12/2026. Front and back yards are free of hazards. Back yard has a shaded seating area for residents to enjoy. The medications are centrally stored and locked in the staff room. The facility uses the Medication Administration Record (MAR) log to document medications given. LPA reviewed medications for all five (5) residents. LPA conducted interviews with two staff. Residents were not available to interview. Per California Code of Regulations, Title 22, and California Health and Safety Code, the deficiencies observed during the visit are documented on the LIC-809D page. Exit interview was held and copies of reports LIC-809, LIC-809C, LIC 809D, and Appeal Rights were discussed and provided to Administrator Maria Clark.the state’s words, verbatim · CDSS document, Aug 20, 2026

Type of visit: Case Management - Annual Continuation

Licensing Program Analysts (LPAs) Elena Mallet and Luis De Leon conducted an unannounced continuation of the annual required visit. LPA met with Administrator Maria Clark. The purpose of today’s visit was explained. The facility is licensed to serve 5 ambulatory and 1 non-ambulatory elderly residents age 59 and over. Currently, there are six (6) resident placements, and one (1) resident is away visiting family. Residents are serviced by Frank D. Lanterman Regional Center. The LPA used the Compliance & Regulatory Enforcement Tool (CARE) during today’s inspection. The visit consisted as follows: REVIEW OF FILES On 8/22/25, LPA conducted a resident record review which consisted of Admission Agreements, Identification and Emergency Info, Consent Report, Individual Program Plan, and Personal Rights. Resident’s P&I money was reviewed for 6 residents. Staff record review consisted of Personnel Report, Health Screening, Criminal Record Statements, Fingerprint Clearance, Training, First Aid and CPR. The facility operation plan, infection control plan and the emergency disaster plan. On today’s visit the following was observed: FACILITY PHYSICAL PLANT The facility is in a two-story building residential area and is made up of five (5) resident bedrooms, three (3) full bathrooms for residents to use, a living room, a kitchen, laundry room, front and backyard, and a detached car garage. There was no body of water observed in the property. Report continues on LIC-809C... Observations during facility tour: Bedrooms were furnished with a bedframe, dresser, lamps, and chairs. LPA observed that there was clean linen, bath towels, and personal hygiene with reasonable closet space available for clients. Wall and floors are in good repair. Hallways were clean and free of obstructions. Kitchen appliances were in working order and clean. There is sufficient two (2) days of perishables and seven (7) day supply of non-perishable food. The dining room has sufficient seating area. Weekly food menu is posted at the facility. The refrigerators and freezer are set at appropriate temperatures. Toilets, showers, and water faucets are found in compliance with Title 22 regulations for temperature and function. Restrooms were stocked and clean. The water temperature was tested and measured. It was found in compliance with Title 22 regulations between 105º and 120º F degrees. Sharps are locked inside the staff room and inaccessible to clients. Also, disinfectants and cleaning supplies are locked and secured inaccessible to clients. Smoke detectors were observed in all bedrooms and carbon monoxide detectors were observed in the living room around the kitchen area. There were three (3) fire extinguishers observed and were fully charged with last inspection on 6/3/25. Last fire drill, earthquake and disaster drill was conducted on 9/15/25. Front and back yards are free of hazards. Back yard has a detached car garage that has been converted into an activity room where residents can enjoy exercise, TV, massages chair, and board games. Clients are assisted with self-administration of prescription and non-prescription medications. The medications are centrally stored and locked in the living room. The facility uses the Medication Administration Record (MAR) log to document medications given. LPA reviewed medications for five (5) out of six (6) residents. One resident is visiting family and took medication to family’s home. LPA conducted interviews with two staff. Two resident interviews were conducted. Per California Code of Regulations, Title 22, and California Health and Safety Code, no deficiencies were observed during the visit. Exit interview held and a copy of the report along was provided to the administrator.the state’s words, verbatim · CDSS document, Sep 23, 2025

Type of visit: Required - 1 Year

License Program Analysts (LPA) Luis De Leon conducted an unannounced annual required visit. LPA met with Administrator Maria Clark. The purpose of today’s visit was explained. The facility is licensed to serve 5 ambulatory and 1 non-ambulatory elderly residents age 59 and over. Currently, there are six (6) resident placement. Residents are serviced by Frank D. Lanterman Regional Center. The LPA use the Compliance & Regulatory Enforcement Tool (CARE) during today’s inspection. The visit consisted as follows: REVIEW OF FILES Resident record review consisted of Admission Agreements, Identification and Emergency Info, Consent Report, Individual Program Plan, and Personal Rights. Resident’s P&I money were reviewed for 6 residents. Staff record review consisted of Personnel Report, Health Screening, Criminal Record Statements, Fingerprint Clearance, Training, First Aid and CPR. The facility operation plan, infection control plan and the emergency disaster plan. During this visits, deficiencies were note on LIC-809D as the facility did not ensure to have medical assessments records for residents R1-R6 and reappraisals for residents R2 and R6. Due to time constraints, LPA will return at a later date to complete all (12) CARE Tool domains. Per California Code of Regulations, Title 22, and California Health and Safety Code, the deficiencies observed during the visit are documented on the LIC-809D page. Reports LIC 809, LIC 809D, and Appeal Rights were discussed and provided to Administrator Maria Clark. Exitthe state’s words, verbatim · CDSS document, Aug 22, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Alma Gonzalez conducted an annual inspection visit. LPA was allowed entry by Administrator Maria Clark. LPA discussed the purpose of today’s visit. . The facility is licensed to serve 6 ambulatory and 1 non-ambulatory elderly residents age 59 and over. Currently, there are six (6) residents placement. The facility consists of : a two story facility which consists of: living room, kitchen with dining area, office, detached laundry room, five (5) bedrooms, three (3) bathrooms. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following: Infection Control: Facility has an Infection Control Plan in place. Operational Requirements: Facility is adhering to the operational requirements. Physical Plant & Environment Safety: LPA toured facility grounds. The furniture in the dining room was adequate and the kitchen was clean. The appliances were working properly. The refrigerators and freezer are set at appropriate temperatures. LPA toured resident rooms which are located on both floors. The facility has smoke detectors and fire extinguisher(s). The hallways and stairway are clear and free of any obstructions. Resident rooms were observed to be clean, properly furnished and have the required linen which were in good condition. There was adequate lighting throughout the facility. All resident rooms had appropriate **Continued on LIC809C** storage for resident's personal belongings. The hot water was tested and was within Title 22 regulations at 107 degrees. Restrooms were observed to be clean, and operational. There is no pool or large bodies of water on the premises. A comfortable temperature was maintained throughout the facility. Staffing: Facility is adhering to staffing requirements. Personnel Records-Training: Staff files are maintained at the facility. LPA reviewed staff files for Facility Administrator and Staff 1-2 (S1-2). Staff have current First Aid/CPR certification. Staff have their Health Screening and Tuberculosis Screening on file. Resident Rights-Information: Resident rights are posted and included in Resident files. Planned Activities: Activity schedule is posted. Food Service: There are sufficient food supplies of 2-day perishable and (1) week of non-perishable items. The food is properly stored in the refrigerator. Posted menu observed. Pesticides and cleaning supplies are kept away from the food preparation areas. Kitchen is kept clean and free from rodents and other vermin. Plates, cups and utensils are kept cleaned and stored properly. Dining areas have adequate seating. Resident Records-Incident Reports: LPA reviewed Resident files for Resident 1-6 (R1-6). Resident files are maintained at the facility. Resident files have the required documents. Disaster Preparedness: The facility has a Disaster Preparedness plan in place. Residents with Special Health Needs: Per Administrator, there are no residents with postural supports and no residents with prohibited health conditions. Per Administrator, there are (0) residents utilizing oxygen equipment. Health Related Services/Incidental Medical Services: The medications are stored/ locked inside the medication room and are inaccessible to residents. Exit interview conducted, and a copy of this report was provided to Administrator Maria Clark.the state’s words, verbatim · CDSS document, Aug 22, 2024