Le Elen Manor, Inc.IV

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Marisol Cuadra, arrived unannounced to conduct an annual required Inspection and met with Licensee/Administrator, Janet Hermogenes. Annual fees are current. LPA/Licensee initiated a tour of the facility at 9:00am and made the following observations: Facility was a comfortable temperature and passageways were free from obstructions. Resident rooms were furnished per regulation. Water temperature in resident bathroom measured 112.3 and 114.1 degrees F which are within allowable range of 105 to 120 degrees F. Extra hygiene products and linens were available. Bathrooms had required bath mats and grab bars. Cabinets containing cleaning supplies were locked. Facility has at least two days of perishable and one week of non-perishable foods. Emergency food supplies observed. Medications were centrally stored and locked in a medication cabinet. Last disaster drill conducted on April 2, 2026. Fire extinguisher was last inspected August, 2025. Smoke detectors and carbon monoxide detector located throughout the facility were tested and operational. Exit doors have auditory alert system and were functional at time of visit. Required postings were observed. Facility doesn't handle cash resources. Medications and medication records were reviewed. File review was initiated at 9:30am. Three staff files and four resident files were reviewed. Staff have required First Aid and CPR certificates. Staff have training required annual hours complete. Administrator Certificate for Administrator, Janet Hermogenes, 7003950740 expires on 10/24/27. Administrator submitted updates of the following: Designation of Administrative Responsibility (LIC308), surety bond, Personnel Report (LIC500) and Administrative Organization (LIC309). No deficiencies cited during today's visit. Exit interview conducted with Licensee and a copy of this report was given.the state’s words, verbatim · CDSS document, May 12, 2026

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Cuadra arrived at facility unannounced to conduct a case management was greeted by staff, Genaro Sampson. Licensee, Janet Hermogenes was available by phone and gave authorization for staff to sign report. During today's visit, LPA explained to Licensee that there is a second notice letter sent to them after unsuccessful attempts via mail on 9/15/25, regarding their outstanding fees in the amount of $742 indicating that if we do not receive evidence that your fees have been paid by 9/23/25, the department may initiate legal action to close the facility. Licensee was made aware of the consequences of not making a payment in a timely manner and provide proof that their fees are current. LPA left second notice letter along with PIN number for them to make an online payment if they want to do so Also, LPA suggested to the Licensee to submit a request to update any of their facility contact information including their phone number to the Department if needed. No deficiencies cited during today's inspection. Exit interview conducted with staff and a copy of this report was given.the state’s words, verbatim · CDSS document, Sep 18, 2025

Type of visit: Case Management - Health Checks

Licensing Program Analyst (LPA) Cuadra arrived unannounced for the purpose of conducting a health check visit and met with Licensee, Janet Hermogenes. This case management inspection is to conduct a health and safety check regarding personal rights ongoing issues discovered on complaint findings. During today's visit, two residents were out of the facility and the other one was napping. LPA observed two staff on duty with the clients in care. According to Licensee, there has not been any incidents or concerns raised regarding personal rights. There were no deficiencies cited today. Exit interview conducted with Licensee and copy of this report was given.the state’s words, verbatim · CDSS document, Aug 1, 2025

Allegation investigated: -Staff yell at residents. -Staff do not allow residents to have visitors.

An informal meeting was conducted today in the Santa Rosa Regional Office to deliver findings. Present in the meeting were Licensing Program Manager Bethany Moellers, Licensing Program Analyst Marisol Cuadra and Licensee of the facility, Janet Hermogenes. The Department received an allegation of staff yell at residents. Per Reporting Party, staff (S1 & S2) yell at clients when they ask for hygiene supplies. Reporting Party witnessed on 4/14/25, while speaking to a client on the phone, they overheard Licensee yelled at client (C1). On 5/13/25, LPA conducted 10-day visit to the facility, conducted confidential interviews with staff and clients in care. Based on confidential interviews conducted with clients in care (C1, C2 & C3) it was revealed that Licensee raises their voice at clients resulting in clients avoid making eye contact or stare at Licensee to reduce the possibility of been yelled at them, they are fearful of retaliation by Licensee and/or risking the stability of their housing. Continue on LIC9099C... Substantiated Continued from LIC9099... A related complaint about Licensee yelling at the residents was previously substantiated see complaint # 21-AS-20241125153637. Although, LPA was unable to receive confirmation from Licensee if this communication approach keeps happening or not; Licensee suggests that their accent when they speak Tagalog with S2 in front of the clients could be the cause of their fear. The preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 6, Chapter 8), is cited on the attached LIC 9099D. Appeal Rights Given. The Department will review information obtained to determine if any further action is needed. Regarding allegation of staff do not allow residents to have visitors. The Reporting Party stated that the Licensee would not allow them to go to the facility to meet with C1 there, after client has asked them and they said no. Based on records review, the facility provided LPA with house rules including visitation hours between 8am to 6pm daily. However, Licensee provided LPA with a written addendum to house rules issued and signed on 5/5/25 by C1 only, where the notice instructs them that visitor, specifically individual (I1) as follow: “I1 needs to call Licensee or S2 ahead of time. Have I1 not to hang out at/or front door in front of the house. Licensee or S2 will ask them to leave”. Based on interviews with Licensee, I1 used to call the facility phone number when they are at the front door during non-visiting hours (10:30pm-11pm) and hangs up, but C1 at times refuses to see I1, but when I1 shows at the door, they will leave together, so Licensee is taking this approach to protect C1 from I1, because according to Licensee C1 doesn’t know how to set boundaries with I1. Although, C1 expressed to LPA that they have not asked the Licensee for it. The preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 6, Chapter 8), is cited on the attached LIC 9099D. Appeal Rights Given. The Department will review information obtained to determine if any further action is needed. Continued from LIC9099A... Based on LPA’s interviews with clients in care and observations, LPA has determined and confirmed that although the facility appeared to be clean and in a sanitary condition on recent LPA inspections conducted on 04/29/25 and 05/13/25, LPA is unable to determine if an area of the facility was unclean or unsanitary condition at a prior date. A finding that the complaint allegation staff do not ensure the facility is clean and sanitary condition is unsubstantiated meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. Another allegation was received regarding staff do not ensure resident has sufficient hygiene products. According to the reporting party, client (C1) has asked the Licensee for more shampoo, and they yelled at them about that. On 5/13/25, LPA conducted 10-day visit to the facility, toured the facility inside and outside with Licensee and it was observed in the facility storage two single boxes of toothpaste, 15 soap bars, one box of Q-tips, three bottles of shampoo, three toothbrushes, two bottles of antibacterial soap (8 ounces) and cleansers available, which are in compliance with agreed basic hygiene items indicated in client’s admissions agreements. Based on confidential interviews with clients (C1, C2 & C3) it was clarified that Licensee do provides hygiene items to them, but not in a pleasant manner when they request such basic items. A finding that the complaint allegation occurs of staff do not ensure resident has sufficient hygiene products is unsubstantiated meaning that although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is UNSUBSTANTIATED.the state’s words, verbatim · CDSS document, Jun 11, 2025 · control 21-AS-20250509113031

From the deficiency page — Deficiency type: Type A · Section cited: HSC 1569.269(a)(1) · Plan of correction due date: Jun 12, 2025

Type A - §1569.269 Enumerated rights; severability (a) Residents of RCFE shall have all of the following rights: (1) To be accorded dignity in their personal relationships with staff, residents, and other persons. This requirement has not been met as evidence by: Based on interviews with residents and staff, the facility Licensee yells at residents resulting in residents are avoiding making eye contact to prevent Licensee from raising their voice at them, which poses an immediate risk to the health and safety of clients in care.the state’s words, verbatim · CDSS document, Jun 11, 2025

Plan of correction: Licensee to ensure all residents are always treated with dignity and respect. Licensee agrees to sign LIC9098 attesting understanding of Health and Safety Code 1569.269, Enumerated Rights by POC due date of 6/12/2025.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87468.1(a)(11) · Plan of correction due date: Jun 20, 2025

Type B -87468.1 Personal Rights of Residents in All Facilities (a) Residents in all RCFE shall have all of the following personal rights: 11) To have their visitors, including…advocacy representatives, permitted to visit privately during reasonable hours & without prior notice, provided that the rights of other residents are not infringed upon…This requirement has not been met as evidence by: Based on records review and interviews conducted with the Licensee. The Licensee did not ensure the compliance of above regulation due to issuing an addendum to visitation policy to C1 only to discourage C1’s visitors from visiting regularly, which it could be a potential personal rights risk to the residents in care.the state’s words, verbatim · CDSS document, Jun 11, 2025

Plan of correction: Licensee will ensure that residents rights are maintained. Licensee will submit a self-certification (LIC9098) that all staff had been notified about regulation by POC due date of 6/20/2025.

Type of visit: Office

An informal meeting was conducted today in the Santa Rosa Regional Office. Present in the meeting were Licensing Program Manager Bethany Moellers, Licensing Program Analyst Marisol Cuadra and Licensee of the facility, Janet Hermogenes. The purpose of the informal conference is to address finding concerns regarding personal rights ongoing issue was discussed with Licensee.the state’s words, verbatim · CDSS document, Jun 11, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Marisol Cuadra, arrived unannounced to conduct an annual required Inspection and met with Administrator, Janet Hermogenes. Annual fees are current. LPA/Administrator initiated a tour of the facility at 9:00am and made the following observations: Facility was a comfortable temperature and passageways were free from obstructions. Resident rooms were furnished per regulation. Water temperature in resident bathroom measured 113.5 and 113.4 degrees F which are within allowable range of 105 to 120 degrees F. Extra hygiene products and linens were available. Bathrooms had required bath mats and grab bars. Cabinets containing cleaning supplies were locked. Facility has at least two days of perishable and one week of non-perishable foods. Emergency food supplies observed. Medications were centrally stored and locked in a medication cabinet. Refrigerated medications were observed in a locked box in a refrigerator located in the kitchen. Last disaster drill conducted on February 8, 2025. Fire extinguisher was last inspected August, 2024. Smoke detectors and carbon monoxide detector located throughout the facility were tested and operational. Exit doors have auditory alert system and were functional at time of visit. Required postings were observed. Facility doesn't handle cash resources. Medications and medication records were reviewed. Contact information was reviewed. File review was initiated at 9:30am. Three staff files and three resident files were reviewed. Staff have required First Aid and CPR certificates. Staff have training required annual hours complete. Administrator Certificate for Administrator, Janet Hermogenes, 6013991740, expires on 10/24/25. Administrator submitted updates of the following documents: Designation of Administrative Responsibility (LIC308), surety bond, liability insurance, Personnel Report (LIC500) and Administrative Organization (LIC309). No deficiencies cited during today's visit. Exit interview conducted with Administrator and a copy of this report was given.the state’s words, verbatim · CDSS document, Apr 29, 2025

Allegation investigated: -Staff is threatening the residents while in care.

Licensing Program Analyst (LPA) Cuadra arrived unannounced to conduct a complaint investigation and deliver findings regarding the above allegations and met with Janet Hermogenes, Licensee. Regarding allegation of staff is threatening the residents while in care. Per the reporting party who was anonymous, the Licensee has been complaining about the hygiene of several of the residents, by threatening to begin bathing them by themselves against their will if they do not improve their hygiene to their standards, at times claiming that they have bathed at least one male at one of their other facilities. Based on LPA’s interviews conducted with residents (R3), it was revealed that the Licensee have commented of the smell of the residents and told them that if they not bath, they would be made to bath. According to the Licensee, residents are allowed to take a bath anytime, there is no set schedule, and they don’t force anybody to take a bath if they refuse to do so, but licensee confirmed that there had been threats made to the residents due to their smell at that time. A complaint about Licensee threatening all the residents related to food services see complaint # 21-AS-20241125153637. The preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 6, Chapter 8), is cited on the attached LIC 9099D. Appeal Rights Given. The Department will review information obtained to determine if any further action is needed. Substantiatedthe state’s words, verbatim · CDSS document, Feb 19, 2025 · control 21-AS-20241216225041

From the deficiency page — Deficiency type: Type A · Section cited: HSC 1569.269(a)(10) · Plan of correction due date: Feb 20, 2025

§1569.269 Enumerated rights; severability (a) Residents of RCFE shall have all of the following rights: (10) To be free from neglect, financial exploitation, involuntary seclusion, punishment, humiliation, intimidation, and verbal, mental, physical, or sexual abuse. This requirement has not been met as evidence by: Based on interviews with residents and staff, the Licensee have commented of the smell of the residents, which poses an immediate risk to the health and safety of clients in care.the state’s words, verbatim · CDSS document, Feb 19, 2025

Plan of correction: Licensee agrees to review regulation 1569.269 (a)(1) with staff, conduct a training with staff, submit self-certification that it has been completed, and personal rights of residents outlined by regulation will never be violated by POC due date.

Allegation investigated: -Personal Rights.

Licensing Program Analyst (LPA) Cuadra arrived unannounced to conduct a complaint investigation and deliver findings regarding the above allegations and met with Janet Hermogenes, Licensee. The Department received an allegation of Personal Rights. Per Reporting party, staff (S1) was observed pressuring resident (R1) to finish their meal even after R1 stated that they didn't want any more. S1 told R1: “your doctor says you need to eat more due to blood sugar balance”. R1 replied: “my doctor said I am not diabetic”. This went on for a couple of rounds and other residents were observed clearly uncomfortable with the psychological abuse of having to witness Licensee’s behavior day after day. Also, Licensee have been observed making fun of R1 and threatening them by saying: “if you can’t do this (referring to chores), then you can’t smoke”. According to the reporting party, all residents are fearful of retaliation by Licensee and/or risking the stability of their housing because Licensee tends to pick on the most vulnerable members of the house and have threatened them by saying: “if they don’t like it, they can give a 30-day notice”. Continue on LIC9099C... Substantiated Continued from LIC9099... Another situation happens when Licensee attends to resident’s psychiatrist appointment by not providing privacy for the residents and the Licensee do not allow residents to participate in the decision-making of their care planning. Based on interviews conducted with residents (R1, R2, R3 & R4) and staff (S1 & S2), it was revealed that Licensee (S1) and staff (S2) yells at residents in average of two to three times per day, S2 yells “why are you wasting food?”, S1 tells another resident “You must eat all your food”, Licensee will yell at another resident because this resident “does not get it”. Licensee confirmed that there is one resident (R1) who had problems with their diet because when R1 was diagnosed with a urinary tract infection (UTI) didn’t want to eat enough as encouraged by their physician to eat a little bit more. However, based on records review of doctor’s visit on 11/6/24 indicates that R1 had elevated glucose reading. LPA was unable to determine if it was consented or not for Licensee to be present at psychiatrist visits. The Licensee also confirmed their presence into the resident’s psychiatrist appointments to get information about their health, but they leave them alone after the Licensee bring up their concerns. Although, LPA was unable to receive confirmation from R1 if this practice bothers them or not. The preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 6, Chapter 8), is cited on the attached LIC 9099D. Appeal Rights Given. The Department will review information obtained to determine if any further action is needed.the state’s words, verbatim · CDSS document, Feb 19, 2025 · control 21-AS-20241125153637

From the deficiency page — Deficiency type: Type A · Section cited: HSC 1569.269(a)(1) · Plan of correction due date: Feb 20, 2025

§1569.269 Enumerated rights; severability (a) Residents of RCFE shall have all of the following rights: (1) To be accorded dignity in their personal relationships with staff, residents, and other persons. This requirement has not been met as evidence by: Based on interviews with residents and staff, the facility staff (S1 & S2) yells at residents in average of two to three times per day and Licensee admitted their presence into the resident’s psychiatrist appointments, which poses an immediate risk to the health and safety of clients in care.the state’s words, verbatim · CDSS document, Feb 19, 2025

Plan of correction: Licensee agrees to review regulation 1569.269 (a)(1) with staff and submit self-certification that it has been completed, and personal rights of residents outlined by regulation will never be violated by POC due date.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Cuadra, arrived unannounced to conduct an annual required Inspection and met with Caregiver, Genaro Samson. Administrator, Janet Hermogenes arrived later. Fees are current. Contact information was reviewed. LPA/staff initiated a tour of the facility at 9:00am and made the following observations: Facility was a comfortable temperature and passageways were free from obstructions. Resident rooms were furnished per regulation. Water temperature in resident bathroom measured between 110.9 degrees F which are within allowable range of 105 to 120 degrees F. Extra hygiene products and linens were available. Bathrooms had required bath mats and grab bars. Cabinets containing cleaning supplies were locked. Drawer containing knives was also locked. Facility has at least two days of perishable and one week of non-perishable foods. Medications were centrally stored and locked in a medication cabinet. Refrigerated medications were observed in a locked box in a refrigerator located in the kitchen. The facility has not conducted a disaster drill within the last quarter. Fire extinguisher was last inspected August, 2023. Smoke detectors and carbon monoxide detector located throughout the facility were tested and operational. Exit doors have auditory alert system and were functional at time of visit. Required postings were observed. Current residents handle their own cash resources. Medications and medication records were reviewed. Continue on LIC809C... Continued from LIC809... File review was initiated at 9:30am. Two staff files and six resident files were reviewed. Five out of six residents do not have a current care plan. One out of six residents admission agreement was not completely filled out a technical violation was issued. Staff have required First Aid and CPR certificates. Training records were reviewed and staff have a maximum average of nine hours of required annual training, staff needs additional required 20 hours of training. Administrator Certificate for Administrator, Janet Hermogenes, 6013991740, expires on 10/24/25. Administrator submitted updates of the following documents: Designation of Administrative Responsibility (LIC308), Personnel Report (LIC500) and Administrative Organization (LIC309). Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Appeal rights given. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted with Administrator and a copy of this report was given.the state’s words, verbatim · CDSS document, May 23, 2024

The state marks this report as 5 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.