<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198600654
Report Date: 08/12/2024
Date Signed: 08/12/2024 09:50:58 AM

Document Has Been Signed on 08/12/2024 09:50 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME:CONTINENTAL GUEST HOMEFACILITY NUMBER:
198600654
ADMINISTRATOR/
DIRECTOR:		RUBERTO BALUYOTFACILITY TYPE:
735
ADDRESS:15482 PASTRANA DRIVETELEPHONE:
(714) 522-3013
CITY:LA MIRADASTATE: CAZIP CODE:
90638
CAPACITY: 4CENSUS: 4DATE:
08/12/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:38 AM
MET WITH:Gina Baluyot - AdministratorTIME VISIT/
INSPECTION COMPLETED:
10:05 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Erik Zaragoza conducted an unannounced case management visit in response to a Corrective Action Plan (CAP) received from the Eastern Los Angeles Regional Center (ELARC). LPA met with Gina Baluyot, administrator for the facility, and explained the purpose of the visit. There are currently four (4) clients residing in the home, three (3) of which are ambulatory and one (1) of which is non-ambulatory.

In the CAP received from ELARC which is dated on 4/1/2024, it details that at the time of the visit, the facility had not conducted a fire, earthquake, or disaster drill within the past six (6) months. During the tour of the home, LPA conducted a tour of the home and found that the facility has a sufficient two (2) day supply of non-perishable food and seven (7) day supply of non-perishable food. LPA tested the hot water temperature in the client bathroom and it measured at 106.8 degrees Fahrenheit, which is within the required range of 105 - 120 degrees Fahrenheit. The facility was in good repair and there were no immediate health or safety concerns. LPA also reviewed the emergency and disaster drills that the facility has been conducting, and found that since the month of April 2024, the staff has conducted emergency and disaster drill in the months of July and in August as well and are now within compliance.

Per California Code of Regulations, Title 22, and California Health and Safety Code, the deficiency observed during the visit is documented on the LIC809D page. Exit interview held and a copy of the report along with appeal rights were provided. Deficiency will be cleared as the correction has already been made.
SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Erik Zaragoza
LICENSING EVALUATOR SIGNATURE: DATE: 08/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/12/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
Document Has Been Signed on 08/12/2024 09:50 AM - It Cannot Be Edited


Created By: Erik Zaragoza On 08/12/2024 at 09:42 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: CONTINENTAL GUEST HOME
FACILITY NUMBER: 198600654

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/12/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/26/2024
Section Cited
CCR
80023(d)

1
2
3
4
5
6
7
(d) Disaster drills shall be conducted at least every six months.


This regulation is not met as evidenced by:
1
2
3
4
5
6
7
**POC Cleared During Visit** Administrator is to ensure that disaster drills are conducted once every 6 months. Administrator is to conduct and emergency and disaster drill and submit it to LPA by the POC dude date.
8
9
10
11
12
13
14
Based on interview and record review, LPA determined that during the CAP visit on 4/1/2024 the facility had not conducted a disaster drill within the past 6 months, which posed a potential health and safety risk to clients in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:David Sicairos
LICENSING EVALUATOR NAME:Erik Zaragoza
LICENSING EVALUATOR SIGNATURE:
DATE: 08/12/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/12/2024


LIC809 (FAS) - (06/04)
Page: 2 of 2