Genesis RCFE

Allegation investigated: -Staff are verbally abusive to residents. -Staff do not provide a comfortable environment for residents in care.

Licensing Program Analyst (LPA) Cuadra arrived unannounced to delivered findings regarding the allegations listed above and met with Darwin Galicia, Administrator. The Department received an allegation of staff are verbally abusive to residents. According to the Reporting Party, on 6/24/2026, resident (R1) disclosed that staff at the facility are verbally abusive with residents. On 6/29/26, LPA conducted 10-day visit to the facility, made observations, reviewed records and conducted confidential interviews with staff (S1, S2 & S3) and residents (R1, R2, R3, R4 & R5). Based on interviews conducted with residents (R1, R2, R3, R4 & R5) LPA learned that there are no instances of verbal abuse between staff and residents’ interactions. Based on records review of residents’ physician reports and care plans indicate that two out of five residents (R2 & R3) has a diagnosis of dementia, but records review did not reveal any evidence to support above allegation. A finding that the complaint allegation of staff is verbally abusive to residents is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is UNSUBSTANTIATED. Continue on LIC9099C... Unsubstantiated Continued from LIC9099... Another allegation of staff does not provide a comfortable environment for residents in care. Reporting party raised concerns about the safety of the residents after resident (R1) disclosed that they and other residents (names unknown) do not always feel safe. No additional details were provided. LPA conducted 10-day visit to the facility on 6/29/26, made observations, reviewed records and conducted confidential interviews with residents (R1, R2, R3, R4 & R5) and staff (S1, S2 & S3) which did not indicate that the environment could be hostile. There were no accounts provided to support the allegation that staff did not provide a comfortable environment, and LPA was not provided with additional information including names, locations, dates, times or any specific incident. The finding that the allegation of staff does not provide a comfortable environment for residents in care is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is UNSUBSTANTIATED.the state’s words, verbatim · CDSS document, Jul 9, 2026 · control 21-AS-20260626100723

Type of visit: Required - 1 Year

02/24/2026, Licensing Program Analyst (LPA) Loera conducted an unannounced Annual Required – 1 yr. inspection visit for this facility. There are currently five (5) residents in care. Facility approved/cleared for six (6) non-ambulatory. LPA was greeted by caregiver. Administrator, Darwin Galicia arrived shortly after. LPA and staff toured the building and grounds. The facility was found to be at a comfortable temperature. LPA observed a 2 day supply of perishable and 7 day supply of non-perishable food. Refrigerated food was found to be stored in a safe manner being labeled and dated. All rooms were furnished per regulation. Extra hygiene products and linens were available. Water temperature in sinks accessible to residents in care were measured and found to be within the range of 105 to 120 degrees F. Fire extinguishers were last inspected December 2025. Smoke/Carbon Monoxide detectors located throughout the facility were tested and operational. LPA observed an activities calendar with various activities for residents to participate in. Chemicals were observed to be inaccessible to residents in care. Facility has a in ground pool that was found to have a locked gate with surrounding fencing. Sharps were located in a kitchen drawer and found to be secured. Medications were found to be centrally stored. LPA conducted spot medication count and found all prescription medication to be properly recorded on the Centrally Stored Medication Record. LPA conducted a review of four resident records. All records had the required documentation, however LPA observed one out of four residents to not have an updated medical assessment. (Deficiency Cited) LPA conducted review of four staff records/training. Upon a review of staff records, LPA found all staff to have required annual training. However LPA found three out of four staff to not have a current 1st Aid & CPR certification on file. (Deficiency Cited) continued on LIC809C Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 03/24/2026: LIC500- Personnel Report LIC308- Designation of Responsibility Updated Certification of Liability Insurance Current Lease The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted and appeal of rights provided.the state’s words, verbatim · CDSS document, Feb 24, 2026

Allegation investigated: Staff are not permitting resident to leave the facility Staff are not permitting resident to have visitors Staff are not permitting resident to receive phone calls Staff did not assist resident with obtaining medical care

Licensing Program Analyst (LPA) Hansen arrived unannounced to deliver complaint investigation findings regarding the above allegations. LPA was greeted by staff Marita Socito who contacted Licensee who was out of the area. LPA spoke with Licensee, disused purpose of visit and authorized staff to sign for today’s visit. During investigation LPA conducted facility visit on 4/8/2025 & 4/22/2025 and made observations, conducted interviews with staff and outside individuals, and obtained and reviewed medical and legal documents to complete this investigation. Staff are not permitting resident to leave the facility – Complainant alleges staff are not allowing resident (R1) to leave the facility. Interviews conducted and documents obtained revealed on (12/24-shopping to Ross, 2/11/25-shopping TJ Max, 3/25 walking around neighborhood, 4/1/25 -Salon-(see pics), 4/8/25 Costco grocery shopping/Hearing aid fix, 4/23/25 Costco grocery shopping/again hearing aid fix, R1 was taken to these appointments by Administrator. Interview with Long Term Care Ombudsman (LTCO) confirmed outings. Continue on LIC9099-C Unsubstantiated Continued from LIC9099: Administrator informed other family members also have taken R1 to doctors’ appointments. Facility restricted access on the directive of the residents Power of Attorney (POA). Review of power of attorney paperwork and legal documents pertaining to restraining order indicates facilities ability to comply with POA’s directive. There was no information obtained during the investigation that supported a violation had occurred. Based on records reviewed, interviews conducted, and related information obtained during the investigation the allegation “staff are not permitting resident to leave the facility” is UNSUBSTANTIATED. Staff are not permitting resident to have visitors- Complainant alleges staff sometimes allow visits from family and friends and sometimes they don't. Interview with Administrator revealed, POA visits 1 to 2X a week & family friends will come approximately once a week. Facility restricted access on the directive of the residents Power of Attorney (POA). This would include people who are attempting to contact R1 on behalf of individuals who have/had restraining orders. Review of power of attorney paperwork and legal documents pertaining to restraining order indicates facilities ability to comply with POA’s directive. There was no information obtained during the investigation that supported a violation had occurred. Therefore, the allegation staff are not permitting resident to have visitors is UNSUBSTANTIATED. Staff are not permitting resident to receive phone calls- Complainant alleges facility staff sometimes don't let resident (R1) receive or make phone calls. Follow up interview with complainant provided conflicting information indicating they have daily phone conversations with R1 and is not sure of specific days, times, or of which staff do not allow calls to R1. LTCO records indicate multiple calls made to and received from R1. Documents obtained of R1’s daily activity log and Interviews conducted with facility and outside professionals revealed; R1 has their own cell phone and has used facility phone. From 2/16/2025 until 4/7/2025 R1 daily logs indicate some of R1’s either made calls or received calls to be approximately 20 times, including a call made to a family member on 4/1/2025. During said call, the police arrived due to a call indicating R1 was not being allowed to use the phone. Police report indicates R1 informed they are able to use the phone whenever and there is no issue. There was no information obtained during the investigation that supported a violation occurred. Therefore, the allegation Staff are not permitting resident to receive phone calls is UNSUBSTANTIATED. Continue on LIC9099-C2 Continued from LIC9099-C Staff did not assist resident with obtaining medical care - Complainant alleges that R1 had a doctor appointment on 4/4/25, and after calling doctor’s office to confirm appointment, stated they spoke to R1 on the phone and R1 allegedly indicated staff are refusing to let them go to appointment even though staff was to take R1 to appointment. The department’s investigation revealed on 4/8/2025 LPA conducted unannounced visit at facility and observed R1 to be in good health and hygiene, walking around facility with a walker and having conversations with other residents, staff and LPA. Interview with administrator revealed R1 did not have a doctors appointment on 4/4/25 but has taken R1 to doctors appointments along with POA. Per Police Report regarding R1, welfare checks on 4/3/2025 & 4/4/2025 alleging facility not allowing R1 to go to hospital on 4/4/2025 and all other allegations appear to be unfounded. There was no information obtained during the investigation that supported a violation occurred. Therefore, the allegation Staff did not assist resident with obtaining medical care is UNSUBSTANTIATED. A finding that the complaint allegations are unsubstantiated means that although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegations are UNSUBSTANTIATED.the state’s words, verbatim · CDSS document, Jul 17, 2025 · control 21-AS-20250404112532

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Shannan Hansen arrived unannounced to conduct a required Annual inspection and was greeted by Caregiver. Administrator Darwin Galicia arrived later. Facility has 4 residents with 1 with dementia diagnosis. Facility has fire clearance for 6 Non Ambulatory and cleared for a Hospice Waiver for 3, although no residents currently are on hospice. At approximately 11 am LPA and staff toured the building and grounds. The facility was found to be clean and at a comfortable temperature. LPA observed at least a 2 day supply of perishable and 7 day supply of non-perishable food. Food was found to be stored in a safe manner with open items covered and labeled. LPA observed locked kitchen cabinet containing cleaning supplies and sharp knives. All bedrooms were equipped with lighting/lamp, night stand, and chest of drawers. All bedrooms were clean and in good repair. Extra hygiene products and linens were available. Resident bathrooms had required slip resistant mats and grab bars. Water temperature in sink(s) accessible to residents in care measured at 107.6 to 107.7 degrees F, within the allowable range of 105 to 120 degrees F. Fire extinguishers were observed to be charged 19/2025. Smoke/Carbon Monoxide detectors located throughout the facility were tested and operational. Exit doors have an auditory alert system that was functional at time of inspection. Facility’s last quarterly disaster drill was conducted on 01/03/2025. At approximately 12 PM, LPA reviewed 4 of 4 resident records and found 4 of 4 residents had current Physician Assessmentss on file although 2 of 4 residents did not have current Pre-Admissions Appraisals on file, (see LIC 809-D) Continue on LIC809-C Continued from 809... At approximately 1:00 PM on 2/5/2025 LPA conducted a review of five out of five staff files and learned that all facility staff present and a sample of other individuals who require caregiver background checks have received criminal record clearances or exemptions. Direct care staff annual training requirements are current and LPA was presented with proof of CPR & 1st Aid certification for staff that files were reviewed. Review of staff records revealed staff #4 & #5 do not have required health screening reports and #4 also does not have TB test results (see LIC809-D). Medication is centrally stored in a locked closet in the hallway. Darwin Galicia Administrator Certificate 6002465740 expires 6/1/2025. All fees are current. LPA and Admin discussed facility's Infection Control Plan and Emergency Disaster plan. The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted and appeal of rights provided. Appeal of Rights Given. LPA Hansen has requested the following documents updated and submitted to CCL by 2/21/2025. LIC500- Personnel Report LIC308- Designation of Responsibility (if changes) LIC9020 Register of Facility Residents Emergency Disaster Plan (if changed) Copy of Current Liability Insurance (when available)the state’s words, verbatim · CDSS document, Feb 6, 2025

The state marks this report as 8 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.

Allegation investigated: Staff did not issue a pre-admissions refund to responsible party

Licensing Program Analyst (LPA) Shannan Hansen arrived unannounced to deliver complaint findings regarding the allegation listed above and met with Licensee/Administrator Darwin Galicia. Staff did not issue a pre-admission refund to responsible party – Complainant alleges Licensee requested and obtained a “move-in-deposit” for perspective individual (I1) to move in to facility, although when I1 suddenly took a turn for the worse and was in the process of dying, facility was informed I1 would not be moving in and sent 3 requests for return of refund that was never responded to by Licensee. The investigation revealed: the department obtained a copy of the document indicating a deposit in the amount of $1,000. was received on 5/14/2024, indicating expected move in date was 5/23/2024. Interviews conducted revealed responsible party notified on 5/21/2024 that I1 would not be moving to the facility due to actively passing. I1 passed away 5/23/2024 and responsible party requested two times in June via email to facilities’ online website & via mail to facility approximately 7/1/2024 to return deposit. Continue on LIC9099-C Substantiated Continued from LIC9099 Licensee was unable to provide a pre-admission appraisal for I1 or an admission agreement. The deposit document obtained is not part of the admission agreement on file with Community Care Licensing (CCL). Deposit received in definition per Health and Safety Code “preadmission fee” means an application fee, processing fee, admission fee, entrance fee, community fee, or other fee, however designated, that is requested or accepted by a licensee of a residential care facility for the elderly prior to admission. Allegation alleged of “Staff did not issue a pre-admission refund to responsible party” is SUBSTANTIATED based on Health & Safety Code 1569.651 (g) If the applicant decides not to enter the facility prior to the facility’s completion of a preadmission appraisal or if the facility fails to provide full written disclosure of the preadmission fee charges and refund conditions, the applicant or the applicant’s representative shall be entitled to a refund of 100 percent of the preadmission fee. Licensee informed on 7/19/2024 that refund was sent to responsible party on 7/19/2024 in the full amount. The following deficiencies were observed (see LIC 9099D) and cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted and appeal of rights provided.the state’s words, verbatim · CDSS document, Sep 4, 2024 · control 21-AS-20240709125043

From the deficiency page — Deficiency type: Type B · Section cited: HSC 1569.651(g) · Plan of correction due date: Sep 6, 2024

(g) If the applicant decides not to enter the facility prior to the facility’s completion of a preadmission appraisal or if the facility fails to provide full written disclosure of the preadmission fee charges and refund conditions, the applicant or the applicant’s representative shall be entitled to a refund of 100 percent of the preadmission fee. This requirement has not been met as evicenced by ***Based on interviews with licensee & outside party and documents obtained, Licensee did not comply with Health & Safety Code regulations provided. This is a potential risk to the health and safety of residents in care.the state’s words, verbatim · CDSS document, Sep 4, 2024

Plan of correction: Licensee agrees to comply with regulation cited and refund due and provide a full copy of the admission agreement including preadmission fee/deposit for departments review. Facility has refunded monies.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Hansen conducted an unannounced annual inspection of this facility and met with Licensee, Darwin Galicia. Facility has 5 residents, none with dementia or under hospice care. Facility tour began: 01/24/2024 at 9:00am with staff Imelda & licensee/administrator Darwin Galicia, facility was found to be clean and at a comfortable temperature with all exits free from obstruction. All notices that are required to be posted have been posted and are in a highly visible areas. Sample tour of resident’s bedrooms, common areas, kitchen & food storage areas were inspected. Facility has at least two days of perishable and one week of non-perishable food. Facility kitchen, refrigerators and freezers were clean, and food was stored properly. Hot water temperature measured between 120.3. degrees F and 121. degrees F in 2 out of 2 resident’s bathroom faucets falling out of Title 22 acceptable regulation of 105 to 120 degrees F , licensee adjusted water heater during visit. Facilities two bathrooms were equipped with non-slip floor mats for safety. There was a supply of cleaners, hygiene products and paper products available for residents. Resident’s bedrooms have lighting & appropriate furnishings. Fire Extinguishers were found to be last charged on 01/11/2024. Smoke Detector and Carbon Monoxide Detector were tested and operational. Toxins are stored in a locked hallway closet & cabinet under sink. Facility maintains a 30-day supply of medication. Facility has no required log of disaster drills conducted which are to be conducted quarterly, in different shifts (see LIC809D). At approximately 10:30AM, LPA reviewed 5 of 5 resident records and found 5 of 5 residents did not have current Pre-Admissions Appraisals on file and 2 of 2 residents needing Re-Appraisals, Licensee did not have on file. (see LIC 809-D) Continue on LIC809-C Physician’s reports (602’s) were current for all residents. 5 of 5 resident records contained current and signed admission agreements on file. Medication records are thorough and contained physician’s orders for each resident. At approximately 12:15 PM, LPA reviewed 4 of 4 staff records, 4 of 4 records did not contain documentation of completed training records as required (see LIC809-D). Evidence of first aid and CPR training were current. All staff either had Covid-19 vaccination documents or exemptions on file. LPA interviewed 2 staff during this inspection. At approximately 1:30PM, LPA reviewed the facility emergency disaster plan with Licensee. Facility is working on getting a generator to supply power during an outage. LPA Hansen reviewed Licensing Information System (LIS) with Licensee who informed all is current. LPA advised facility to contact Local County Public Health and DSS/CCL Community Care Licensing if more than 3 COVID-19 + in the facility. Administrator Certificate is for Darwin Galicia # 6002465740 Exp. 6/1/2025. The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted and appeal of rights provided. Appeal of Rights Given. LPA Hansen is requesting Licensee to update and submit the following documents to CCL by 2/9/2024 LIC 308 Designated LIC 500 Personnel Summary LIC 610 Emergency Disaster Plan LIC 9020 Register of Facility Resident’s Updated facility sketch showing exit door in rm 5 Copy of Administrator Certificate Copy of Certificate of Liability Insurancethe state’s words, verbatim · CDSS document, Jan 24, 2024

The state marks this report as 6 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.