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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 336412357
Report Date: 03/03/2025
Date Signed: 03/03/2025 02:46:34 PM

Document Has Been Signed on 03/03/2025 02:46 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, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:SLB INC-HONORS WAYFACILITY NUMBER:
336412357
ADMINISTRATOR/
DIRECTOR:		JEFFREY CASTILLOFACILITY TYPE:
735
ADDRESS:26938 HONORS WAYTELEPHONE:
(951) 776-0424
CITY:MORENO VALLEYSTATE: CAZIP CODE:
92555
CAPACITY: 6CENSUS: 5DATE:
03/03/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:15 PM
MET WITH:ADMINISTRATOR, JEFFREY CASTILLOTIME VISIT/
INSPECTION COMPLETED:
02:50 PM
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On March 03, 2025, Licensing Program Analyst (LPA), Venus Mixson arrived at the facility unannounced to conduct the Required Annual Inspection and met with Jeffrey Castillo, Administrator. The facility file review was conducted at the Regional Office and additional records were requested and reviewed on site. The facility is licensed for six Adults and is currently operating at a capacity of five Adults (735).

LPA Mixson toured the facility along with the Administrator, Jeffrey Castillo and made observations. LPA inspected the facility inside and outside there were no obstructions or debris to the indoor or outdoor passageways. Additionally, there were no bodies of water on the premises. The facility is a single-story home located 26938 Honors Way Moreno Valley CA. 92555.

Physical Plant: The facility phone number is (951) 776-0424 and it is operable. LPA Mixson observed the residents’ bedrooms, and each was equipped with required furniture as per Title 22. LPA Mixson inspected facility bathrooms, and the hot water temperature tested within regulations. The bathrooms were clean, and appliances were operating appropriately. The facility is equipped with operating smoke detectors, carbon monoxide alarms, and fire extinguishers. Riverside County Marshals services the fire extinguisher on Marsh 2024.

LPA Mixson observed required postings such as "If you See Something, Say Something,” the PUB 475, and the "Personal Rights." The cleaning supplies and sharp items were kept locked and inaccessible to the residents in care. There was a designated storage space for staff files, and it was locked and inaccessible to residents in care currently at the time of this visit. Residents files were maintained online and reviewed with tablet.

SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Venus Mixson
LICENSING EVALUATOR SIGNATURE: DATE: 03/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/03/2025
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, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: SLB INC-HONORS WAY
FACILITY NUMBER: 336412357
VISIT DATE: 03/03/2025
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Medications: Were locked and inaccessible to residents in care, and there was a sufficient supply of medication for each resident. The overall facility is clean, the furniture is in good condition. The facility heating system and other appliances were operable currently at the time of this visit. Administrator informed LPA there were safety lights for night throughout the facility.

Food Service: Non-perishable and perishable food supply is sufficient per regulations, and there are a variety of food types available for residents. Dishes and utensils were in sufficient supply and stored properly, and sharp items are locked.

Care & Supervision/Administration: Adequate staff are present for the supervision of residents in care. Floor plans, telephone numbers and personal rights were found posted in the facility. The listed administrator possesses a current administrator’s certificate with an expiration date of 04/20/2026.

Records Reviewed and Resident/Staff Files: LPA reviewed staff files and reviewed the facility's staff schedule. The staff files reviewed possessed all required paperwork. Residents files reviewed on line required forms were current and up to date.



Disaster preparedness: LPA Mixson reviewed the facility's emergency and disaster plan as well as disaster training binder. LPA observed the last fire drill met the department standards.

Infection Control: LPA Mixson observed the hand washing stations in the facility restrooms. LPA observed PPE equipment and cleaning supplies to do regular cleaning of the facility. LPA reviewed the facility's infection control plan and found all required infection control measures.



There were no TA deficiencies observed or cited per Title 22, Division 6 of the California Code of Regulations at this time.
An exit interview was conducted where a copy of this report was discussed and given to Jeffrey Castillo, Administrator.
SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Venus Mixson
LICENSING EVALUATOR SIGNATURE:

DATE: 03/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2025
LIC809 (FAS) - (06/04)
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