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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198603566
Report Date: 01/16/2025
Date Signed: 01/16/2025 10:42:47 AM

Document Has Been Signed on 01/16/2025 10:42 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
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME:ASTORIA PARK SENIOR LIVINGFACILITY NUMBER:
198603566
ADMINISTRATOR/
DIRECTOR:
STEPHANIE FUNDERBURGFACILITY TYPE:
740
ADDRESS:925 EAST VILLA STREETTELEPHONE:
(626) 796-4303
CITY:PASADENASTATE: CAZIP CODE:
91106
CAPACITY: 220TOTAL ENROLLED CHILDREN: 0CENSUS: 130DATE:
01/16/2025
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Michelle Castillo - Community Liason DirectorTIME VISIT/
INSPECTION COMPLETED:
11:00 AM
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Licensing Program Analyst (LPA) Mary Flores conducted an unannounced case management - health and safety check visit regarding reported incident on relocation of 2 residents from Foothill Heights Care Center due to mandatory evacuation orders from the Fire Advisory. LPA met with Michelle Castillo and explained the reason for the visit.

During the visit today, LPA Flores conducted a health and safety check by touring the facility. No immediate health and safety concerns were observed. LPA obtained a copy of the resident and staff roster.

Per interview with the administrator, there are 2 residents that have been relocated from Foothill Heights Care Center. Facility is fully staff and nurses have been visiting the 2 residents daily. Administrator has been in contact with Pasadena Public Health Nurse and Ombudsman, who have visited the residents. Food and hygiene supplies are available to accommodate all the residents. LPA reviewed medications and MAR logs for the 2 residents that were transferred to the facility and are centrally stored and inaccessible to the residents. The last fire drill was conducted on 12/17/24.

LPA discussed with administrator proper relocation of resident #1 who has a prohibited health condition and there is no enrollment in hospice care. Per administrator they are currently working on it. Due to the situation most skill nursing facilities are full at this time. However, will continue to seek proper placement.

An exit interview was held and a copy of this report was given to the Stephanie Funderburg Administrator and a copy of this report was provided.
Tony VasalloTELEPHONE: (818) 419-8131
Mary G FloresTELEPHONE: (323) 981-3965
DATE: 01/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/16/2025
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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