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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 370808534
Report Date: 07/14/2022
Date Signed: 07/14/2022 11:36:19 AM

Document Has Been Signed on 07/14/2022 11:36 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
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME:GUILAS BOARD AND CARE HOMEFACILITY NUMBER:
370808534
ADMINISTRATOR:MA. ELENA GUILASFACILITY TYPE:
735
ADDRESS:1185 NACION AVENUETELEPHONE:
(619) 585-8474
CITY:CHULA VISTASTATE: CAZIP CODE:
91911
CAPACITY: 6CENSUS: 6DATE:
07/14/2022
TYPE OF VISIT:CollateralUNANNOUNCEDTIME BEGAN:
10:20 AM
MET WITH:Administrator, Elena Guilas, and Caregiver, Arminda FloresTIME COMPLETED:
11:45 AM
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Licensing Program Analyst (LPA), Sabel Martinez, conducted a collateral visit to interview Resident #1 (R1). The LPA was greeted by Caregiver, Arminda Flores, introduced himself, and disclosed the purpose of the visit. Administrator, Elena Guilas, arrived during the visit and was informed of the purpose of the visit.

During today's visit, the LPA interviewed R1. No deficiencies were cited on today's date.

An exit interview was conducted with Administrator, Elena Guilas, to whom a copy of this report, LIC 811 and Licensee’s Rights (LIC 9098 01/16) were provided to.
SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Sabel Martinez
LICENSING EVALUATOR SIGNATURE: DATE: 07/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/14/2022
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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