Facility Evaluation Report

Licensing Program Analyst (LPA) Elena Mallett conducted the required annual inspection. LPA arrived unannounced and met with Administrator Cynthia Pabalan. The purpose for today’s visit was explained. The facility is licensed to serve 6 elderly residents ages 60 and above, with bedrooms 1,2,3 approved for non-ambulatory and bedroom 4 approved for bedridden. There is a hospice waiver for 6 residents. There are currently no bedridden residents. Two residents are 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. Staff are cleaning and disinfecting throughout the day. Facility has sufficient PPE supplies and has an Infection Control Plan maintained at the facility.

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.