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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 370802865
Report Date: 08/22/2024
Date Signed: 08/23/2024 03:38:08 PM

Document Has Been Signed on 08/23/2024 03:38 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
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME:ORLANDO GUEST HOMEFACILITY NUMBER:
370802865
ADMINISTRATOR/
DIRECTOR:		CYRALYNN MABALOTFACILITY TYPE:
735
ADDRESS:297 -299 ORLANDOTELEPHONE:
(619) 444-9411
CITY:EL CAJONSTATE: CAZIP CODE:
92021
CAPACITY: 34CENSUS: 42DATE:
08/22/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Licensee Cyra MabalotTIME VISIT/
INSPECTION COMPLETED:
02:30 PM
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Licensing Program Analyst (LPA) Liliana Silveira conducted an unannounced visit to conduct a POC clearance visit. LPA identified herself, disclosed the purpose of the visit and was allowed entry by LPA Leni Huertas. Licensee Cyra Mabalot arrived shortly after.

During the POC visit, LPA conducted a walk-through of the facility and interviewed staff and the Licensee.

No citations were issued during today's visit.

An exit interview was conducted, and a copy of this report and Licensee Rights (9058 03/22) were provided to Cyra, whose signature on this form confirms receipt of these documents.
SUPERVISORS NAME: Jennifer Lott
LICENSING EVALUATOR NAME: Liliana Silveira
LICENSING EVALUATOR SIGNATURE: DATE: 08/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/22/2024
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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