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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 392700604
Report Date: 07/26/2023
Date Signed: 07/27/2023 10:12:10 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 07/27/2023 10:12 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
SACRAMENTO AC/SC, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME:CASTLE ROAD HOMEFACILITY NUMBER:
392700604
ADMINISTRATOR:PERRY-HYLTON, SHERRYFACILITY TYPE:
735
ADDRESS:14012 CASTLE RDTELEPHONE:
(209) 823-6061
CITY:MANTECASTATE: CAZIP CODE:
95336
CAPACITY: 6CENSUS: 0DATE:
07/26/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:No One PresentTIME COMPLETED:
01:00 PM
NARRATIVE
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Unannounced annual visit made out to this facility on 07/26/2023 by Licensing Program Analyst (LPA) Charlie Yang. This LPA approached the facility and attempted to make contact with facility personnel at this time. This LPA rang the doorbell several times and waited for several minutes.
This LPA did not observe any movement from within the facility nor did this LPA hear any sounds from within this facility at this time.
This LPA retreated back to his vehicle and attempted to make contact, via the phone number, available for this facility.
It was learned that all facility residents attended their respective day programs daily and were not present at this time. It was learned that facility residents were picked up as early as 7:30 am and the last resident left at 8:30 am.
It was learned that facility residents did not return to this facility until 3:30 pm.
As a result, since there weren't any facility residents present at the facility then there weren't any staff present as well.
It was learned that the facility staff left shortly after the last resident was picked up for their day program usually around 9:00am. The facility staff did not return back to this facility until 2:30 pm.
This LPA will have to reschedule this visit with the facility designated Administrator, Melinda Womble, at a later date and time.

Exit Interview
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Charlie Yang
LICENSING EVALUATOR SIGNATURE: DATE: 07/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/26/2023
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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