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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198600050
Report Date: 04/30/2024
Date Signed: 04/30/2024 03:07:58 PM

Document Has Been Signed on 04/30/2024 03:07 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME:GENUS RESIDENTIAL CAREFACILITY NUMBER:
198600050
ADMINISTRATOR/
DIRECTOR:		SARITA E. WELLINGTONFACILITY TYPE:
735
ADDRESS:8356 MAXINE STREETTELEPHONE:
(562) 861-9486
CITY:PICO RIVERASTATE: CAZIP CODE:
90660
CAPACITY: 4CENSUS: 4DATE:
04/30/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:42 PM
MET WITH:Imelda Sanchez - CaregiverTIME VISIT/
INSPECTION COMPLETED:
03:25 PM
NARRATIVE
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Licensing Program Analysts (LPAs) Erik Zaragoza and Daniel Konishi conducted an unannounced case management visit to follow up on a semi-annual residential review that was conducted by the East Los Angeles Regional Center (ELARC). LPAs met with Imelda Sanchez, caregiver for the facility, and was granted entrance into the facility. Administrator Janice Harrison arrived shortly thereafter.

The visit was conducted in response to a report received that indicated that the facility did had perishables that were spoiled in the refrigerator along with non-perishable canned food that were expired. Additionally the report indicated that the Personal and Incidental (P&I) monies for the clients were comingled as well rather than being kept separate.

During the visit, the LPAs toured the food supply and found that there were a sufficient supply of perishable and non-perishable foods. There were some non-perishable canned foods in the emergency food supplies that were still expired, however the majority of the cans were still within their expiration date and therefore good for consumption. LPAs also checked the P&I monies for the clients and observed that they were kept in separate envelopes with their names on it and their money separated. LPAs checked the hot water temperature in the client's restroom and observed that it measured at 107.2 Degrees F. LPAs also observed that knives and all chemicals and cleaning supplies are kept locked and inaccessible to clients. LPAs checked the fire alarms in the facility and found that they were operational. LPAs also conducted a tour of the remaining rooms of the facility and found that there were not immediate health and safety risks.

The deficiencies will be noted on the LIC809D pages. Exit interview held and a copy of the report was provided to administrator Janice Harrison.
SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Erik Zaragoza
LICENSING EVALUATOR SIGNATURE: DATE: 04/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/30/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
Document Has Been Signed on 04/30/2024 03:07 PM - It Cannot Be Edited


Created By: Erik Zaragoza On 04/30/2024 at 02:47 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: GENUS RESIDENTIAL CARE
FACILITY NUMBER: 198600050

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/30/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/17/2024
Section Cited
CCR
80076(a)(7)

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(a) In facilities providing meals to clients, the following shall apply: (7) Commercial foods (...) shall be selected, transported, stored, prepared and served so as to be free from contamination and spoilage and shall be fit for human consumption.
This regulation is not met as evidenced by:
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Administrator is to ensure that all food contained at the facility is not spoiled or expired. Administrator is to remove all expired foods from the facility and ensure all food kept at the facility is fit for human consumption by the POC due date.
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Based on record review of the regional centers report, LPAs determined that there were some non-perishable foods that were kept in the emergency food supply, along with moldy sour cream in the refridgerator, which posed a potential health and safety risk for clients in care.
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Type B
05/17/2024
Section Cited
CCR80026(e)

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(e) Cash resources, personal property, and valuables of clients shall be separate and intact, and shall not be commingled with facility funds or petty cash.

This regulation is not met as evidenced by:
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Administrator is to ensure that all client P&I funds will remain separate and not comingled moving forward. Administrator is to separate the clients P&I funds and keep them separated moving forward by the POC due date.
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Based on record review and interviews, LPAs determined that at one point the P&I monies for the clients were comingled, which posed a potential health and safety risk for clients in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:David Sicairos
LICENSING EVALUATOR NAME:Erik Zaragoza
LICENSING EVALUATOR SIGNATURE:
DATE: 04/30/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/30/2024


LIC809 (FAS) - (06/04)
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