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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198600692
Report Date: 05/07/2024
Date Signed: 05/07/2024 11:06:31 AM

Document Has Been Signed on 05/07/2024 11:06 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
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME:GUIDING LIGHT HOME 2FACILITY NUMBER:
198600692
ADMINISTRATOR/
DIRECTOR:		PASCASIO, ZONEL E.FACILITY TYPE:
735
ADDRESS:4828 CUTLER AVENUETELEPHONE:
(626) 814-4783
CITY:BALDWIN PARKSTATE: CAZIP CODE:
91706
CAPACITY: 5CENSUS: 5DATE:
05/07/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:21 AM
MET WITH:RAQUEL AMOR DSPTIME VISIT/
INSPECTION COMPLETED:
11:15 AM
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Licensing Program Analyst (LPA) Christian Gutierrez conducted an unannounced annual inspection using the Compliance and Regulatory Enforcement (CARE) tools. LPA met with DSP Raquel Amor and explained the visit. Zonel Pascasio (Administrator) arrived shortly and assisted with visit.

The facility is licensed to serve five (5) ambulatory, develop-mentally disabled adults. The facility is a single-story house. The facility includes dining area, living room, kitchen, four client’s bedrooms, two bathrooms, office room and an attached garage.

LPA Gutierrez conducted a tour of the facility, reviewed records, and interviewed 2 staff and 2 clients. The following were observed: Three (3) Client bedrooms have the required furniture such as bed frames, dressers, lamps, and chairs. Bedroom Two (2) did not have a chair accessible to client. Technical violation (TV) was given and chair was placed in bedroom. Bedrooms also have sufficient closet space. Client beds have the required linen. Smoke detectors were observed throughout the facility and were tested and operable during the visit. There is a carbon monoxide detector located in the dining room area. Sharps are locked in a kitchen drawer and are inaccessible to clients. Cleaning supplies and toxins are locked in the garage and are inaccessible to clients. First Aid kit was fully stocked with current manual. There is a fire extinguisher located in the kitchen which is fully charged. Sufficient supply of 2 days perishable & 7 days non-perishable foods was observed. The front and backyard are well maintained and there are no pools or large bodies of water. There is a shaded seating area for the clients located in the back patio. Passageways and exits are free of obstruction.

Four (4) staff files were reviewed and included Criminal clearance record, CPR/training, and health screening with TB. Five (5) client files were reviewed and included physicians report, TB clearance, and individual program plan (IPP)report. Last fire/earthquake drill was conducted in January 2024. Infectious control plan was reviewed. Two (2) staff and (2) clients were interviewed. Five (5) out of (5) client medications were reviewed. Medications are centrally stored and locked MAR log is used. No deficiencies were observed during this visit per Tile 22.

Exit interview was conducted with Maria Didasa and a copy of this report was provided.

SUPERVISORS NAME: Tony Vasallo
LICENSING EVALUATOR NAME: Christian Gutierrez
LICENSING EVALUATOR SIGNATURE: DATE: 05/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/07/2024
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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