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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
197609913
Report Date:
11/23/2022
Date Signed:
11/23/2022 01:36:22 PM
Document Has Been Signed on
11/23/2022 01:36 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
N LA & CEN COA AC/SC
,
21731 VENTURA BLVD., STE. 250
WOODLAND HILLS
,
CA
91364
FACILITY NAME:
GUINTO HOME CARE II
FACILITY NUMBER:
197609913
ADMINISTRATOR:
GUINTO, ALMA
FACILITY TYPE:
735
ADDRESS:
9037 EAST AVENUE R10
TELEPHONE:
(661) 874-6390
CITY:
LITTLEROCK
STATE:
CA
ZIP CODE:
93543
CAPACITY:
4
CENSUS:
4
DATE:
11/23/2022
TYPE OF VISIT:
Required - 1 Year
UNANNOUNCED
TIME BEGAN:
12:10 PM
MET WITH:
Alma Guinto
TIME COMPLETED:
01:35 PM
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On 11/23/2022 at 12:10 p.m. Licensing Program Analyst (LPA) Evelin Rios arrived at the facility mentioned above in order to conduct a Required Annual visit. LPA was greeted by staff #1 (S1) and was granted access. LPA explained reason for the visit. LPA called the administrator Alma Guinto of reason for visit. Alma said she would meet me at the facility shortly. Alma arrived shortly after.
LPA had temperature taken and Covid-19 screening questions asked. LPA reviewed facilities mitigation plan that was approved 03/30/2021 The inspection tool was used to complete the visit. Proper Covid-19 signs were observed posted through out the facility. The facility has dual smoke detectors and carbon monoxide. At 12:28 p.m. all smoke alarms were tested and functioning properly. The fire extinguisher was observed in the kitchen and was last serviced on 11/24/2021.
No deficiencies were observed during todays visit and the facility is currently following their infection control plan.
Exit interview conducted and report issued.
SUPERVISORS NAME
:
Eva Miller
LICENSING EVALUATOR NAME
:
Evelin Rios
LICENSING EVALUATOR SIGNATURE
:
DATE:
11/23/2022
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
11/23/2022
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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