197609088-3-18-2025-31-AS-ERIS-DEVUNA-20250318154338

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197609088
Report Date: 03/18/2025
Date Signed: 03/18/2025 03:43:45 PM

Document Has Been Signed on 03/18/2025 03:43 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
N LA & CEN COA AC/SC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME:	ASHTON CASTLE		FACILITY NUMBER:	197609088
ADMINISTRATOR/ DIRECTOR:	CASTILLO, IMELDA M		FACILITY TYPE:	740
ADDRESS:	3322 ASHTON PLACE		TELEPHONE:	(818) 645-0652
CITY:	LANCASTER	STATE: CA	ZIP CODE:	93536
CAPACITY: 6	TOTAL ENROLLED CHILDREN: 0	CENSUS: 4	DATE:	03/18/2025
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:32 AM
MET WITH:	Imelda Castillo / Licensee		TIME VISIT/ INSPECTION COMPLETED:	03:53 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 03/18/2025 at 9:32 a.m., Licensing Program Analyst (LPA) Evelin Rios conducted an unannounced annual required inspection. LPA arrived at the facility and was greeted by staff #1 (S1) and was granted entry. Once inside LPA met with the Licensee, Imelda Castillo and LPA disclosed the purpose of the inspection. Four (4) residents, S1 and including the Licensee were present. At approximately 10:00 a.m. LPA accompanied by Licenses began a physical plant tour of the facility inside. LPA began the inspection at the front of the facility where there are two vacant resident bedrooms, one staff bedroom, and one bathroom. LPA observed appropriate postings on the walls near the entry. LPA observed a formal dining area, clean and clear of clutter with a dining table and enough chairs to sit the capacity of the facility. LPA observed night lights on a hallway and a thermostat that read 70 degrees Fahrenheit. Opposite the thermostat LPA observed a closet where extra pantry and emergency food is stored. Bedrooms currently occupied by residents of which one (1) is shared, were observed clean, properly furnished and had appropriate bedding and linens. Exterior doors in bedrooms were equipped with auditory alarms. Alarms were tested and observed operational. Extra linens were available in a designated linen closet. There are three (3) bathrooms, one (1) of which is located in the shared resident bedroom for private use. All bathrooms were clean, properly supplied with hand soap, paper towels, grab bars and shower mats. All bathrooms had hand washing signs and a pull cord to call for assistance. Hot water temperature was measured at approximately 10:24 a.m., in two (2) out of three (3) bathrooms and read between 118.4 and 119.1 degrees Fahrenheit, within regulation. LPA observed a door labeled laundry room that was locked. In the laundry room LPA observed a washer and dryer that were operable. Laundry detergent is kept in the closed cabinets above the washer and dryer. Through the laundry room is the attached garage that stores that facility's emergency water, supplies, a second refrigerator and a freezer to store the overflow of food. (Continue to LIC809-C)

Eva Miller	TELEPHONE: (818) 596-4373
Evelin Rios	TELEPHONE: 424-299-6104
	DATE: 03/18/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 2

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
N LA & CEN COA AC/SC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: ASHTON CASTLE	FACILITY NUMBER: 197609088
	VISIT DATE: 03/18/2025

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Licensee tested the dual smoke and carbon monoxide detectors in the facility at 10:12 a.m., LPA observed them operational.

The kitchen was observed by LPA to be clean and clear of clutter. The appliances and fixtures were observed functional. LPA found a sufficient amount of two day perishable and seven day non-perishable supply of food at the facility; properly stored. LPA observed cutlery and dishware in good repair for residents. LPA observed properly labeled medications locked in a kitchen cabinet. LPA observed a small locked fridge used for medications requiring refrigeration. A fire extinguisher was observed in the kitchen area to be fully charged and last serviced 01/09/2025.

LPA inspected the backyard and the side of the house. No visible hazards where observed and all passageways were free of obstructions. There are two shaded areas for residents to use.

At approximately 10:30 a.m., four (4) staff records were reviewed to insure compliance and current training. At approximately 11:30 a.m., LPA reviewed four (4) out four (4) resident records to insure compliance. LPA was informed by licensee, a new resident was admitted today and documentation would be completed by end of day. Review of new resident's file revealed resident did have a pre appraisal, medical assessment and medication records.

Centrally Stored Medication and Destruction Records were reviewed ay 12:18 p.m., for proper documentation. Medication records were complete and updated. Facility also keeps Medication Administration Records (MAR).

No deficiencies issued during this visit. Exit Interview conducted. Copy of report provided.

SUPERVISOR'S NAME: Eva Miller	TELEPHONE: (818) 596-4373
LICENSING EVALUATOR NAME: Evelin Rios	TELEPHONE: 424-299-6104
LICENSING EVALUATOR SIGNATURE:	DATE: 03/18/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2025

LIC809 (FAS) - (06/04)

Page: 2 of 2