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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197609913
Report Date: 11/09/2021
Date Signed: 11/09/2021 01:43:44 PM

Document Has Been Signed on 11/09/2021 01:43 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
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME:GUINTO HOME CARE IIFACILITY NUMBER:
197609913
ADMINISTRATOR:GUINTO, ALMAFACILITY TYPE:
735
ADDRESS:9037 EAST AVENUE R10TELEPHONE:
(661) 874-6390
CITY:LITTLEROCKSTATE: CAZIP CODE:
93543
CAPACITY: 4CENSUS: 4DATE:
11/09/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:50 PM
MET WITH:Alma Guinto, AdministratorTIME COMPLETED:
02:10 PM
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Licensing Program Analysts (LPAs) Shira Stamps and Angela Panushkina, met with Administrator Alma Guinto for an unannounced one (1) year Required visit for this facility.

LPAs arrived at 12:50pm and was greeted by Caregiver Norma. LPAs informed the caregiver of the purpose of the visit. The caregiver called the Administrator, and LPA Panushkina spoke to the Administrator at 12:55pm. One (1) client was observed in the kitchen doing a craft project. The rest of the clients were observed to be in their room, watching TV and/or resting. The Administrator, Alma Guinto arrived approximately at 1:15pm. LPAs informed the Administrator of the purpose of the visit.


Infection control: LPA Stamps reviewed facility mitigation plan (approved on 03/30/21) to make sure the licensee was following the current infection control recommendations. Upon arrival the team was screened by the caregiver and asked all infection control questions. LPAs were asked to sign-in and sanitize/wash hands.


A tour of the physical plant was conducted with Caregiver Norma at 1:00pm. The facility has four (4) bedrooms and two (2) bathrooms. One (1) bedroom is designated for staff use only. The facility is Fire Cleared for four(4) ambulatory.

Resident Rooms
LPAs observed rooms to have the appropriate bedding. There is a night stand and sufficient lighting for each resident.

Continued.....
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Shira Stamps
LICENSING EVALUATOR SIGNATURE: DATE: 11/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/09/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: GUINTO HOME CARE II
FACILITY NUMBER: 197609913
VISIT DATE: 11/09/2021
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Bathrooms
At 1:10pm LPAs observed all bathrooms to have non-skid matts, and the appropriated wash your hands signs posted. Hot water was tested at 1:05pm and measured within regulation at 119.1 degrees F.

Food Inspection
LPAs conducted a tour of the kitchen around 1:00pm observed there to be sufficient stock of two-day perishables and seven-day non-perishables foods. Frozen foods are properly wrapped and stored appropriately. Food storage and preparation areas care clean and inaccessible to pests. LPAs observed all knives and sharp objects locked and inaccessible to clients in care.

Physical environment
LPAs toured the outside area of the facility at 1:20pm. LPA observed appropriate outdoor furniture, with a covered shaded area for clients. No bodies of water on the premises.

Living and dining
LPAs observed the living room to be neat and clean along with the dining room. The facility maintains a comfortable temperature at 77°F. The smoke detectors and carbon monoxide were tested and observed to be operational at 1:06pm. There is one(1) fire extinguisher, located in the kitchen. Fire extinguisher was observed to be full and last serviced on 12/02/20. Medication cabinet was located in the kitchen area and at 1:00pm; was observed to be locked and inaccessible to clients in care.
Garage
LPAs observed the garage to be attached to the facility and currently being used for an extra food storage and PPE supplies.
Laundry
LPAs observed chemicals/hazardous items in a locked cabinet in the laundry area located in the garage.

Administrative: LPA collected Certificate of Liability Insurance and LIC.500. An exit interview was conducted, and a copy of this report was given to the Administrator.
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Shira Stamps
LICENSING EVALUATOR SIGNATURE:

DATE: 11/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2021
LIC809 (FAS) - (06/04)
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