Rolyn Home

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA)Elena Mallett conducted an unannounced visit to the facility to conduct an Annual Visit. LPA met with House Manager Eadgitha Manalad and explained the purpose for today’s visit. House Manager contacted Administrator Ronald Manalad on the phone and LPA spoke with Administrator about the visit. The facility is licensed to serve developmentally disabled adults 4 Non-Ambulatory Residents and 2 ambulatory residents ages 60 and above. Residents receive services from the Harbor Regional Center. The facility is a single-story home located in a residential area in Norwalk, CA. A tour of the facility includes: 4 resident bedrooms, 2 bathrooms, 2 staff bedrooms, kitchen, dining area, living room, front yard and back yard and detached garage. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today's visit observed the following: Infection Control: Staff are cleaning and disinfecting throughout the day. Facility has sufficient PPE supplies and has an Infection Control Plan maintained at the facility. Facility has a designated Infection control lead. Operational Requirements: The facility maintains the required liability insurance and Surety Bond. The facility has a fire clearance. LPA observed P & I Ledgers for all the residents who received P& I and no issues were observed. Continued on 809-C Physical Plant & Environment Safety: LPA toured facility. The facility is well maintained and walkways and hallways are free of debris and obstruction. Residents’ bedrooms were checked and contained the required furnishings and sufficient closet/drawer space to accommodate each resident comfortably. Sufficient light, towels and bed linens were observed. The backyard is free of debris/hazards and the outdoor and indoor passageways are free of obstruction. No bodies of water were observed at the facility. A shaded table and outdoor furniture were present to allow the residents to enjoy the outdoors. There are no security bars or weapons on the premises. Hygiene products are readily available for clients. The hot water temperature was measured in both bathroom faucets and was measured within Title 22 requirements of 105 degrees F- 120. Grab bars and non slip floor material was observed. Smoke detectors were observed in the hallway and in each resident's room. Smoke detectors and a carbon monoxide detector were tested and observed to be functional. There was a fire extinguisher present that was observed to be fully charged. All storage areas for cleaning solutions, toxins, knives, sharps and hazardous items are kept locked and inaccessible to residents LPA observed that a bathroom located in a resident's private room was being utilized by staff and other residents. A deficiency was cited. See 809-D LPA observed that two staff bedrooms that did not appear on the facility sketch were present. Per Administrator these staff bedrooms had been constructed from the existing living room and did not require building permits. Administrator did not provide LPA with proof that the bedroom construction did not require building permits. A deficiency was cited. See 809-D. LPA observed that the constructed staff bedrooms did not contain smoke detectors and only one bedroom contained windows. Staffing: There appears to be sufficient staffing at all times in the facility. The night staff that is trained and able to assist in care and supervision of the residents in the case of an emergency. Personnel Records-Training: Staff files are kept in a secure location. LPA reviewed 5 staff files. Files were reviewed for Criminal Record Clearance, Health Screening and Current First Aid and initial and ongoing training for care of the Elderly. No issues were observed. Administrator’s certificate is current until 09/10/27. Resident Records-Incident Reports: Resident files are kept in a secure location and have the following documents in their files - Pre-admission appraisal/Appraisal Needs & Services Plan, Medical Consent, Admission Agreements, Identification & Emergency Information and current Physician's Report. LPA reviewed 4 Resident Files and a deficiency was observed. See 809-D. House Manager was advised to document inventory of resident personal items. Residents Rights-Information: Residents are provided with telephone and internet at the facility. All the required postings were observed. Planned Activities: Facility offers activities like crafts, trips to the mall, to church, to the park and out to eat. There is a central TV viewing area for residents to enjoy together. There is an outdoor furnished patio area available for the residents. An activity calendar was observed. Food Service: The kitchen was observed for the ability to prepare and serve food. LPA observed an appropriate food supply of two (2) days of perishables and one week (7 days) of non-perishables. Food was stored separately from cleaners, toxins and poisons. Appliances were observed to be operable and able to properly store and prepare food. Incidental Medical & Dental: Medication is properly labeled and are centrally stored in a locked closet and are in their original containers. LPA reviewed 4 residents’ medications and there were no issues observed. Disaster Preparedness: The facility has an Emergency Disaster Plan with contact numbers and at least 2 relocation sites. Emergency food and water were observed. Disaster food and water was observed. A full First Aid kit and Manual were available. The facility does quarterly disaster drills but was overdue for second quarter drill with the last drill being conducted in January 2026. A technical violation was given. Residents with Special Health Needs: No residents at the facility have special health needs. Per California Code of Regulations, Title 22, and California Health and Safety Code, deficiencies observed during today’s visit are documented on the 809(D). Exit interview was held with House Manager Eadgitha Manalad and a copy of this Licensing report was provided along with Appeal Rights.the state’s words, verbatim · CDSS document, Jul 3, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Daniel Konishi conducted a required unannounced annual inspection using the Inspection Tool. LPA met with Lead Staff, Eadgitha Manalad and the purpose of the visit was discussed. Staff #1 (S1) assisted in the tour of the facility. LPA met with Ronald Manalad shortly after and LPA explained the purpose of the visit. 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: Infection control practices and Personal Protective Equipment (PPEs) were observed. LPA observed that the facility has an infection control plan in place. Operational Requirements: Fire clearance was approved by LA County Fire Department for six (6) residents, four (4) of which can be non-ambulatory. Liability Insurance is confirmed and currently on file. Physical Plant/Environment Safety: LPA conducted a tour of the facility with S1 and observed the following: The facility is part of a single-story home located in a residential area and contains the following: living room, TV room, dining room, kitchen with refrigerator, oven, stove, dishwasher, sink/faucet, (4) resident rooms, (2) bathroom for residents, toilet and washbasin, and A back yard with shaded area and seating for resident use. Physical Plant/Environment Safety [Cont.]: There’s a laundry area with a washer and dryer. All passageways, walkways, driveway, steps and patio are free from obstructions. The front, back and side areas of the house are free of hazards. Hallway linen closet: Contained plenty of linens, towels, and hygiene products. Beds have the required furniture including bed frames, nightstands, dressers, lamps, and chairs. Beds have the required linen and the linen is in good condition. Fire extinguisher was observed on hallway last reviewed 05/13/2025. Carbon monoxide detectors are tested and in working condition. Cleaning supplies are kept locked under kitchen sink away from food supplies. Sharps are kept locked in a kitchen drawer. Shared client bathrooms were observed to be clean and contained soap and paper towels. Signs promoting hand washing were observed. Water temperature in this bathroom#1 was measured at 109.0 degrees F and Bathroom #2 was measured at 113.8 degrees F which is in the required 105 – 120 degrees F per Title 22 Regulations. Staffing: A total of three (3) full-time staff members provide care and supervision to the residents. Personnel Records/Staff Training: Administrator’s certificate is active and effective through 09/10/2025. Three (3) staff files were reviewed for criminal background clearance and training. Staff Files include personnel records, health/TB screenings, employee rights, and 1st Aid/CPR/AED training. Resident Rights/Information: Residential Care Facility for the Elderly Complaint Poster (PUB 475) posted on the wall. Residents’ Personal Rights posted on the wall. Facility provides internet access for residents. Planned Activities: The facility has planned activities with monthly activity calendar and activity log. Facility has sufficient space to accommodate indoor and outdoor activities that are easily accessible. Food Service: The kitchen was inspected and has sufficient supply of 2-day perishable & 7-day non-perishable food. Kitchen, food preparation area, and storage areas were observed to be clean and sanitary. Incidental Medical and Dental: Residents are assisted with self-administration of prescription and non-prescription medications. Two (2) centrally stored resident medication records were reviewed. Centrally stored medications are kept in a safe and locked place not accessible to residents in care. Medications are given according to Physician directions. Resident Records/Incident Reports: LPA reviewed two (2) resident files containing admission agreements, Physician's Report, medical/functional assessments, TB clearance, Appraisal/Needs and Services Plan, personal rights, and P & I money were reviewed. However, based on record review, LPA observed that Resident #1 (R1) did not have an updated medical assessment in file. Disaster Preparedness: A posted Emergency Disaster Plan LIC 610D containing emergency evacuation information was observed. An emergency drill was conducted in 06/01/2025. No manual restraints or seclusions are used in residents in care. Residents with Special Health Needs: There are no residents with postural support at this facility. The facility is free from odors of incontinence. LPA interviewed two (2) staff and LPA attempted to interview two (2) residents but LPA was unable to interview the two (2) residents since both residents were unable to answer questions on the day of the visit. Per California Code of Regulations, Title 22, and California Health and Safety Code, the deficiencies observed during the visit are documented on the LIC809-D. Exit interview, appeals rights and a copy of this report were provided to the as provided to the Lead Staff, Eadgitha Manalad.the state’s words, verbatim · CDSS document, Aug 12, 2025

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Elizabeth Irra conducted an unannounced Case Management visit. LPA met with Eadgitha "Jody" Manalad/S-1 and discussed the purpose of today's visit. The purpose of today's visit is to follow up an incident involving C-1 and C-2. It was alleged that C-1 attempted to "smother" C-2 and that C-1 stole C-2's belongings. During this visit, LPA obtained a copy of the staff and client rosters, reviewed and obtained documentation from Client #1 (C-1) and Client #2 (C-2) files, interviewed C-1 and C-2, interviewed Staff #1 (S-1) through Staff #3 (S-3) and interviewed the Quality Assurance Representative from Harbor Regional Center. LPA was unable to interview Client #3 (C-3) due to a language barrier. Staff interviews and reviewed documentation revealed that C-1 has a history of fabricating stories. Interviewed staff indicated that they have not received any complaints pertaining to this allegation. C-2 denies this incident. No deficiencies cited as there was not enough evidence to support the allegation. Exit interview conducted and a copy of this report was provided to Eadgitha "Jody" Manalad/S-1.the state’s words, verbatim · CDSS document, Nov 21, 2024

Allegation investigated: Facility staff handled resident in a rough manner. Facility staff did not provide resident with a call bell. Facility staff spoke inappropriately to resident.

Licensing Program Analyst (LPA) Cynthia Chan conducted the complaint investigation on 11/12/24. LPA arrived unannounced and met with Staff Eadgitha Manalad. The purpose of the visit was explained. LPA toured the facility and obtained copies of documents pertaining to Resident #1. Interviews were held with the Administrator, Staff #1 - #4, Residents #1 - #3, and the Harbor Regional Center Service Coordinator. The investigation revealed the following: Allegation – Facility staff handled Resident in a rough manner. It is alleged that Staff #1 (S1) pulled Resident #1’s (R1) leg too hard, causing it to pop. LPA interviewed the administrator, Staff, and Residents regarding this allegation. All the Staff denied handling residents in a rough manner. S1 denied pulling R1’s leg. S1 stated that R1 needed to be rotated during diaper change so that resident can be cleaned thoroughly and to adjust the diaper. Unsubstantiated S1 denied hearing a pop sound and did not think resident was handled roughly but said that R1 demanded an apology in which S1 did. The administrator and staff were not aware of this occurrence until R1 reported to a third party. They stated R1 will let them know of any concerns, however, R1 did not mention this incident to them. Two of the residents interviewed do not feel that staff are being rough with them. Allegation – Facility staff did not provide resident with a call bell. The administrator and staff stated the call bell is placed next to R1 on the bed to request for staff’s assistance. In addition, the door is open or closed based on resident’s preference. They stated that R1 will usually call out the names of the staff instead of using the bell. Staff said that R1 has the tendency of dropping the bell from the bed and when staff see it on the floor, they will pick it up and put it back on the bed. Staff denied closing the bedroom door against resident’s wish to prevent staff from hearing them. Staff stated they check on residents throughout the day and will assist them at night when needed. Staff will ask residents if they want their doors open or closed. During the tour, LPA observed the bell in R1’s room and the door propped slightly open. Residents interviewed stated the staff assist them when needed. Allegation – Facility staff spoke inappropriately to resident. The administrator and staff denied yelling or accusing resident of being too noisy or bothersome to others. If a resident is being loud, staff would ask resident to lower the voice and explain the reason. They do not yell or raise their voice at them. Staff stated sometimes they talk loudly but not in a way to disrespect others. Staff are cautious with their choice of words and do not say or do anything that will violate their personal rights. Two of the residents stated that staff do not yell or say inappropriate things to them. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED. An exit interview was conducted with the E. Manalad. A copy of this report along with the appeal rights was provided.the state’s words, verbatim · CDSS document, Nov 12, 2024 · control 28-AS-20241105160017

Type of visit: Required - 1 Year

Licensing Program Analysts (LPAs) Daniel Konishi and Christine Wong, conducted a required unannounced annual inspection using the Inspection Tool. LPA met with Staff#1 (S1), Eadgitha Manalad and the purpose of the visit was discussed. S1 assisted in the tour of the facility. The following (CARE) tool domains were observed and reviewed: Infection Control, Physical Plant/Environment Safety, Operational Requirements, Resident Rights/Information, and Food Service. Infection Control: · Infection control practices and Personal Protective Equipment (PPEs) were observed. LPA observed that the facility has no infection control plan in place. Physical Plant/Environment Safety: · LPA conducted a tour of the facility with S1, staff and observed the following: The facility is part of a single-story home located in a residential area and contains the following: living room, TV room, dining room, kitchen with refrigerator, oven, stove, dishwasher, sink/faucet, (4) resident rooms, (2) bathroom for residents, toilet and washbasin. A back yard with shaded area and seating for resident use. There’s a laundry area; with washer and dryer. · All passageways, walkways, driveway, steps and patio are free from obstructions. The front, back and side areas of the house are free of hazards. · Hallway linen closet: Contained plenty of linens, towels, and hygiene products. · Beds have the required furniture including bedframes, night stands, dressers, lamps, and chairs. Beds have the required linen and the linen is in good condition. · Fire extinguisher was observed on hallway last reviewed 04/10/2024. · Carbon monoxide detectors are tested and in working condition. · Cleaning supplies are kept locked under kitchen sink away from food supplies. · Sharps are kept locked in a kitchen drawer. · Shared client bathrooms were observed to be clean and contained soap and paper towels. Signs promoting hand washing were observed. Water temperature in this bathroom#1 was measured at 108.1 degrees F and Bathroom #2 was measured at 107.9 degrees F which is in the required 105 – 120 degrees F per Title 22 Regulations. Operational Requirements: · Fire clearance was approved by LA County Fire Department for six (6) residents, four (4) of which can be non-ambulatory. · Liability Insurance is confirmed and currently on file. Resident Rights/Information: · Residential Care Facility for the Elderly Complaint Poster (PUB 475) posted on the wall. · Residents’ Personal Rights posted on the wall. · Facility provides internet access for residents. Food Service: · The kitchen was inspected and has sufficient supply of 2-day perishable & 7-day non-perishable food. Kitchen, food preparation area, and storage areas were observed to be clean and sanitary. Due to time constraints, LPA will return at a later date to complete 7 more CARE Tool domains. Exit interview conducted with Staff, Eadgitha Manalad and a copy of this report was provided.the state’s words, verbatim · CDSS document, Jul 16, 2024

Allegation investigated: Client does not feel safe in the home. Client is scared of the home staff.

Licensing Program Analyst (LPA) Christian Gutierrez and Licensing Program Manager (LPM) Tony Vasallo conducted a subsequent complaint visit to investigate the allegations listed above. LPA Nicol Wesley conducted initial visit on 5/20/2024. LPA and LPM met with DSP Worker Eadgith Manalad and explained the reason for the visit. The investigation consisted of the following: Obtain documents of resident and staff files, conduct staff, and resident interviews. Requested a copy of staff and resident roster. The investigation revealed the following: Allegation #1 Resident does not feel safe in the home. Allegation #2 Resident is scared of home staff. Its alleged Residents #1 (R1) complains of pain and is ignored and told they are drama and exaggerates. Continued on 9099C. Unsubstantiated Four out of four staff interviewed did not collaborate this allegation and they are unaware of any residents feeling unsafe. Staff denied any abuse in home. Three out of four residents were present and interviewed. It was confirmed Residents #2 (R2) is nonverbal therefore unable to be interviewed. Other two residents interviewed cannot give detailed responses to questions and answers were inconsistent. However, both residents reported feeling safe at home. R1’s records were reviewed. R1’s Individual Program Plan (IPP) dated 11/20/23 revealed R1 has a history of false allegations and fabricating mistreatment by staff. Five staff records were reviewed and did not contain any disciplinary actions. Based on interviews conducted and records reviewed there was insufficient evidence to collaborate these allegations. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated. Exit interview held. A copy of the report was provided.the state’s words, verbatim · CDSS document, Jun 14, 2024 · control 28-AS-20240510120215