565850521-2-24-2025-29-AS-MARO-DE7SBB-20250224124339

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 565850521
Report Date: 02/24/2025
Date Signed: 02/24/2025 12:44:13 PM

Document Has Been Signed on 02/24/2025 12:44 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
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME:	GUIDING PATH HOME		FACILITY NUMBER:	565850521
ADMINISTRATOR/ DIRECTOR:	INSULAR, BETSY		FACILITY TYPE:	735
ADDRESS:	2264 GRAFTON STREET		TELEPHONE:	(949) 350-1343
CITY:	SIMI VALLEY	STATE: CA	ZIP CODE:	93063
CAPACITY: 4		CENSUS: 2	DATE:	02/24/2025
TYPE OF VISIT:	Post Licensing	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:30 AM
MET WITH:	Betsy Insular		TIME VISIT/ INSPECTION COMPLETED:	01:00 PM

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Licensing Program Analyst (LPA) Martha Arroyo conducted an unannounced Post-Licensing Inspection today. Upon arrival, the LPA met with Administrator, Betsy Insular and at this time, the reason for the visit was explained. Entrance interview conducted.

Starting at 10:04AM, the LPA along with the Administrator toured the physical plant to ensure there are no health and safety concerns and the facility is in compliance with Title 22 regulations. The following was observed:

KITCHEN: Appliances and fixtures appeared clean and functional. There was sufficient perishable and non-perishable food and water supply. Knives and other sharps were observed to be locked under the kitchen sink. At 10:08AM, the kitchen sink was measured for hot water temperature, and it measured 115.5 degrees Fahrenheit.

BEDROOMS: There are four (4) bedrooms designated for resident use. All bedrooms were observed and contained appropriate furniture, bedding and linens. The LPA observed two (2) additional bedrooms designated for staff use only. Additional clean linens and towels for resident use were observed in a hall closet. Personal hygiene items were observed in a locked hallway closet at the time of the visit.

BATHROOMS: There are two (2) bathrooms designated for resident use. One bathroom is in the main hallway and the second bathroom is located inside bedroom #3. All restrooms were supplied with appropriate paper and hygiene products. Starting at 10:15AM, the water temperature was measured in both resident bathrooms and they measured within the required range at the time of the visit.

COMMON AREAS: These include the living room and dining room. In the common areas, walls, flooring and furniture was observed and all were in good condition at the time of the visit. The facility maintained a comfortable temperature.

Report Continued on LIC 809C...

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Martha Arroyo
LICENSING EVALUATOR SIGNATURE:	DATE: 02/24/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2025

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: GUIDING PATH HOME	FACILITY NUMBER: 565850521
	VISIT DATE: 02/24/2025

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Report Continued from LIC 809...

The LPA observed activities for resident use by the main hallway. An adequate supply of emergency food and water was observed; properly stored. Required postings were observed throughout the common space. Fire extinguisher was observed to be new with a purchase date of 04/19/2024.

OUTDOOR / BACKYARD: The backyard includes both paved and landscaped areas. The LPA observed a shaded patio with appropriate furniture for outdoor use. There is a laundry room outdoors, which includes a washer and dryer. Residents are encouraged to do their own laundry; however, staff will assist if needed. Detergents and toxins were observed stored in a locked cabinet inside the laundry room. The LPA observed one self-latching gate for emergency use. No bodies of water noted at the time of the visit. All passageways were observed to be clear and free from hazards.

GARAGE: The garage was observed attached to the house. Cleaning supplies and toxins were observed in a locked cabinet at the time of the visit.

FILE REVIEW: The LPA reviewed four (4) staff records during today's visit. All staff files were complete and contained all documents. The LPA also reviewed two (2) resident file records during the visit, which were observed to be complete.

INFECTION CONTROL/DISASTER PREPAREDNESS: During today’s visit, the LPA reviewed the facility's infection control policy and disaster preparedness policies. All items reviewed were in compliance. Emergency disaster drills conducted quarterly as per regulation; the last one being a fire drill which was conducted on 02/02/2025.

MEDICATIONS: Medications are centrally stored in a locked cabinet by the kitchen. The LPA observed medications for one (1) resident as the other resident is currently not taking any medications. Medications were observed to be administered and documented in compliance with regulation.

INTERVIEWS: During today's visit, the LPA interviewed one (1) resident.

No citations issued. Exit interview conducted. Today’s report was reviewed and provided.

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Martha Arroyo
LICENSING EVALUATOR SIGNATURE:	DATE: 02/24/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2025

LIC809 (FAS) - (06/04)

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