Facility Evaluation Report

Licensing Program Analyst (LPA) Elena Mallett conducted an unannounced annual inspection of the facility. LPA arrived and met with Administrator Designee Cynthia Pabalan. The purpose of today’s visit was explained. Administrator Nathan Lacson joined the visit shortly after. The facility is licensed to serve 6 elderly residents, non-ambulatory residents, one of which may be bedridden, ages 60 and above. There is hospice waiver for 6. Bedrooms 1,2,3 approved for non-ambulatory and bedroom 4 approved for bedridden. There are currently no bedridden residents. One resident is on hospice.

The facility is a single-story home located in a residential area in Norwalk, Ca. A tour of the facility includes: living room, kitchen, dining area, 4 bedrooms (2 double and 2 single), 2 bathrooms (1 bathroom located in client room), front yard, back yard, attached garage with laundry.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today’s visit and the initial visit and observed the following:

Infection Control: The facility staff are using appropriate hand hygiene and gloves while assisting residents’ medications. Staff are cleaning and disinfecting throughout the day. Facility has sufficient PPE supplies and has an Infection Control Plan maintained at the facility and a designated Infection Control Lead.

Operational Requirements: The facility has an approved fire clearance, there is a plan of operation with required Infection Control Plan, Dementia Plan and training, and facility maintains the required current liability insurance.