Dept Of State Hospitals - Metropolitan Snf
Inspection Findings
F-Tag F0609
F 0609 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
while being confined in a local custody facility, they shall immediately: notify a physician in all cases of any suspected physical . complete a report of Suspected Dependent Adult/Elder Abuse (Form SOC 341) . if an allegation was never reported . forward a courtesy report . report to California Department of Public Health. verify notifications have been made; to include Program Management, Standards Compliance, and the Office of Law Enforcement Support.During a review of the facility's policy and procedure (P&P) titled, Rape or Sexual Assault of Elder/Dependent Adult (Actual or Alleged), dated 4/1/2025, the P&P indicated, Procedures to be implemented immediately upon the discovery of a case of alleged sexual assault. The unit supervisor or designee will notify the patient's Program Director or designee and the Department of Protective Services (DPS) immediately, and complete form SOC-341. An incident report must be prepared by the reporting treatment unit. is required to report the facts to a local law enforcement agency.
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Printed: 04/13/2026 Form Approved OMB No. 0938-0391
Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION
(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:
(X2) MULTIPLE CONSTRUCTION
B. Wing
A. Building
(X3) DATE SURVEY COMPLETED
11/14/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Dept of State Hospitals - Metropolitan Snf
11401 South Bloomfield Avenue Norwalk, CA 90650
For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG
SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)
F-Tag F0940
F 0940
Develop, implement, and/or maintain an effective training program for all new and existing staff members.
Level of Harm - Minimal harm or potential for actual harm
Based on interview and record review, the facility failed to complete an annual performance evaluation on Psychiatric Technician (PT 1) for eight years. This failure had the potential to prevent PT 1 and other employees from acquiring the necessary skills to meet their job expectations.Findings:During a concurrent
interview and record review on 9/23/2025 at 2:15 p.m. with the Staff Services Manager HR (SSMHR), PT 1's employee file was reviewed. PT 1 was hired in November 2017 and never had an employee performance evaluation completed. SSMHR stated there should have been eight employee performance evaluations for PT 1 and it was not normal for the evaluations to be missing. SSMHR further stated the performance evaluations were to be completed annually.During an interview on 9/25/2025 at 11:37 a.m. with the Unit Supervisor (US), US confirmed she did not complete any performance evaluations for PT 1.
US stated, it was an oversight. US further stated performance evaluations were necessary to provide feedback and education to an employee.During a review of the facility's policy and procedure (P&P) titled, Performance Appraisal and Employee Development, dated 11/28/2023, the P&P indicated, All supervisors and managers will prepare Form 638 (Performance Appraisal Summary) on employees assigned to them at least once each year.
Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
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DEPT OF STATE HOSPITALS - METROPOLITAN SNF in NORWALK, CA inspection on recent inspection.
Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.
Frequently Asked Questions
- What is an F-tag violation?
- F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
- Were these violations corrected?
- Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
- How often do nursing home inspections happen?
- CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
- What should families do about these violations?
- Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in NORWALK, CA, (5) Report new concerns to state authorities.
- Where can I see the full inspection report?
- Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from DEPT OF STATE HOSPITALS - METROPOLITAN SNF or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.