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Inspection visit

Routine inspection

GENESIS MANOR VILicense 3664244245 citations on this visit
5 citations recorded

Inspector’s narrative

What the inspector wrote

Licensing Program Analysts (LPAs), LaVette Farlow and Michelle Echeverria arrived at the Genesis Manor VI facility unannounced to conduct the Annual Inspection. LPAs was greeted by Caregiver, Marietta Tecson and invited inside. Caregiver Mariette contacted the Administrator, Marya Alpert, who arrived later during the visit. Also, during the two other representative arrived during the visit Elyssa Kimble, and Alaina Hendricks. The facility is a residential Home comprised of 6 bedrooms, 2 bathrooms, kitchen, dining room, backyard and attached garage, and staff living quarters. LPAs conducted a general inspection, which include, but was not limited to the following: Physical Plant - The facility is approved for six, (6) non-ambulatory residents, 1 of which may be bedridden. There is a Hospice Waiver in place for three (3) residents. The current census is 5. LPAs reviewed residents files, toured the facility, and reviewed the facility sketch. LPAs observed two residents who are bedridden who were not in the designated bedridden approved bedroom. Fire clearance and Community Care License (CCL) granted a license for only one bedridden resident in room #6 that has an emergency exit to the backyard. Deficiencies with civil penalties cited . The facility is maintained in comfortable temperature. Interior pathways were free of clutter. LPA inspected 5 resident rooms, and one bedroom was under construction and was unable to be inspected. Each room included all required furniture such as sufficient storage space, lighting, mattress with proper linens, night stands, in tact windows and seating. Please see LIC809-C There are 2 bathrooms. LPAs were only able to inspect one resident bathroom due to construction being completed on the bedroom #4 with a bathroom inside. LPAs tested the water temperature in the bathroom and kitchen. During the LPAs initial testing, the water measured at 134.5 and 136.6. LPAs were asked to conduct a retest with Elyssa. During the retest the water measured at 126.9 and Elyssa asked to aim it at a different position of the water flow and the measurement kept rising. Elyssa did not allow the measurement to be completed. Elyssa stated when she tested the water, it measured 119-122 Fahrenheit. Deficiency cited . The bathroom was equipped with handrails, non-slip grip materials, and adequate amounts of hand hygiene & paper supplies. LPAs observed cleaning supplies under the bathroom sink such as Ajax, and a liquid cleaning solution. LPAs advised Caregiver to remove and secure the supplies. A Deficiency cited. LPAs observed fully charged fire extinguishers throughout the facility is also equipped with operable fire and carbon monoxide alarms. Administrator, reported the facility conducts fire/disaster drills on a monthly basis. Last drill conducted December 2025. Near the front entrance of the facility, LPAs observed posters for Infection Control, Resident/Personal Rights, Emergency Contact Info. Facility Sketches with Evacuation Routes, Facility Roster, LTC Ombudsman and the Theft & Loss Policy. The facility maintains emergency food supplies and first aid kits readily available to those who may need it. Food Service : LPA observed the facility's food supply, kept in the refrigerator, freezer and 2 pantries. LPA noted milk, bread, eggs, cheese, fresh vegetables, and a variety of frozen food accessible to residents in care. Amounts of food sufficient for the number of residents in care. LPA's observed some expired parmesan cheese and peanut butter in the pantry. A Deficiency cited. LPAs observed a lock on the refrigerator and pantry. LPAs inquired about the cabinet and refrigerator being locked. Administrator stated it was due to a prior resident that wanders at night. Administrator removed the locks from the refrigerator and cabinet/pantry. Sharps and cleaning supplies are maintained securely under the kitchen sink. LPA also observed dishware, cups, and utensils were adequate in amount and properly stored. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. There were three staff members present at the time of LPA's inspection. ***Please LIC-809C*** Record Review: LPA reviewed, three 3 resident files for admission agreements, updated physician reports, and needs and services plans. LPA's observed the Telecommunications Device Notification form was not signed by the resident or residents responsible party. A Technical Violation issued . LPA also reviewed 4 staff files for First Aid/CPR certification, criminal record clearance, training, and health screenings. LPA's noticed the Administrator renewal application certificate was submitted in January 2026 which is a month after the Administrator certificate expiration date. A Technical Violation issued. LPA's audit residents medication and observed one (1) out of two (2) residents bubble did not match the number of medication issued to the number of medication in the bubble pack. LPA's observed and interviewed staff. A Deficiency cited . Overall, the facility is clean, in good repair, and operating in safe conditions for residents in care. Based on observations, five (5) Deficiencies, and two (2) Technical Violation cited per Title 22, California Code of Regulations. A copy of this report LIC809, LIC809C, LIC809D, LIC9102TV, LIC421IM and appeal rights were provided to Administrator, Marya Alpert.

Citations

5 citations recorded*CCLD

What does Type A vs Type B mean?

Type A. Serious citation. Imminent or substantial risk to children. The regulator requires corrective action immediately and may impose a civil penalty.

Type B. Lower-severity citation. Corrective action required, no imminent risk. The regulator monitors compliance on the next visit.

  • 87204(a)Type A

    Based on observation, interview and record review, the administrator did not comply with the section cited above by having two bedridden residents in a licensed and fire clearance capacity for 1 bedridden resident which poses an immediate health, safety or personal rights risk to persons in care.

  • 87309(a)(1)Type A

    Based on observation, the administrator did not comply with the section cited above by having cleaning supplies in the residents bathroom under the sink and not locked and secured which poses an immediate health, safety or personal rights risk to persons in care.

  • 87202(a)(2)Type A

    Based on observation, interview and record review, the administrator did not comply with the section cited above by having two bedridden residents occupying two separate nonambulatory bedrooms which poses an immediate health, safety or personal rights risk to persons in care.

  • 87465(a)(4)Type A

    Based on observation, interview and record review, the administrator did not comply with the section cited above by not maintaining an accurate centrally stored medication record where 1 out of 2 residents bubble pack did not match the number of medication remaining in the bubble from the start date the medication was administered. There was less medication available to be dispensed. The medication start date was 1/12/2026 and only one medication remained in the bubble pack. which poses an immediate health, safety or personal rights risk to persons in care.

  • 87555(b)(8)Type A

    Based on observation, the administrator did not comply with the section cited above by having an expired parmesan grated cheese and peanut butter in the pantry which poses an immediate health, safety or personal rights risk to persons in care.

FAQ · About this visit

Common questions about this visit

What happened during the February 5, 2026 inspection of GENESIS MANOR VI?

This was a inspection inspection of GENESIS MANOR VI on February 5, 2026. 5 citations were issued: 5 Type A (serious).

Were any citations issued to GENESIS MANOR VI on February 5, 2026?

Yes, 5 citations were issued (5 Type A, 0 Type B). The first citation was for: "Based on observation, interview and record review, the administrator did not comply with the section cited above by havi..."

What type of inspection was this?

This was a inspection inspection. inspection inspections are conducted by CCLD as part of their licensing oversight.

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