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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079201170
Report Date: 11/21/2022
Date Signed: 11/21/2022 02:38:58 PM


Document Has Been Signed on 11/21/2022 02:38 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
CCLD Regional Office, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612



FACILITY NAME:ASTER GARDEN CARE HOME, INCFACILITY NUMBER:
079201170
ADMINISTRATOR:RHU, JINYOUNGFACILITY TYPE:
740
ADDRESS:2046 ARNOLD DRIVETELEPHONE:
(925) 407-7065
CITY:MARTINEZSTATE: CAZIP CODE:
94553
CAPACITY:6CENSUS: 0DATE:
11/21/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Jinyoung Rhu, AdministratorTIME COMPLETED:
02:50 PM
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On 11/21/22 at 1:30 p.m., Licensing Program Analysts (LPAs) G. Clark and Lori Alexander arrived unannounced to conduct pre-licensing inspection. LPAs met with Administrator, Jinyoung Rhu and explained the purpose of the visit. The facility currently has no residents.

LPAs toured facility including but not limited to: bedrooms, bathrooms, kitchen, common areas and backyard. Bedrooms and living rooms were equipped with the proper furniture. Bathrooms were equipped with grab bars and non-skid mats. Linens and hygiene supplies were observed inside a cabinet. There is sufficient lighting throughout facility. Room temperature was maintained at 70 degrees F and hot water temperature was maintained at 112.4 degrees F. First-aid kit was observed to be complete. Smoke detectors and carbon monoxide were operational. Fire extinguisher was last serviced on 4/26/22.

No issues noted during inspection. LPAs observed that facility is ready to be licensed. This report will be submitted to the Central Applications Unit (CAU) and a final review of the application will be conducted. This facility is not yet licensed, and is subject to final approval by CAU. Additional requirements may still be required.

Exit interview conducted and a copy of this report provided.
SUPERVISOR'S NAME: Yvonne Flores-LariosTELEPHONE: (510) 286-0517
LICENSING EVALUATOR NAME: Gregory ClarkTELEPHONE: 510-285-3927
LICENSING EVALUATOR SIGNATURE:
DATE: 11/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/21/2022
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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