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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 345920060
Report Date: 01/30/2025
Date Signed: 01/30/2025 04:20:47 PM

Document Has Been Signed on 01/30/2025 04:20 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 NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:GASTON COMMUNITIES #1FACILITY NUMBER:
345920060
ADMINISTRATOR/
DIRECTOR:		GASTON, TODDFACILITY TYPE:
740
ADDRESS:8131 TREECREST AVETELEPHONE:
(916) 844-7410
CITY:FAIR OAKSSTATE: CAZIP CODE:
95628
CAPACITY: 6CENSUS: 0DATE:
01/30/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:00 PM
MET WITH:Todd Gaston, AdministratorTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
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Licensing Program Analyst (LPA) Michael Hood arrived at the facility unannounced on 1/30/25 to conduct a Required-1 Year Inspection utilizing the inspection tool.

There are no residents residing at the facility at this time. LPA conducted an inspection of the care home to ensure compliance with Title 22 regulations. There are four (4) bedrooms and two (2) bathrooms for resident use. LPA observed facility to be properly furnished with appropriate bedding and lighting in the bedrooms. Bathrooms were in sanitary condition and properly maintained. Hot water temperature was observed to be 116.5 degrees F.

LPA checked the kitchen area for the ability to prepare and store food. LPA observed knives, cleaning products, and other toxins to be locked away and inaccessible. LPA observed the backyard and perimeter of the care home to be free of clutter and debris. LPA observed smoke detectors and carbon monoxide detectors to be operational in the care home. First aid kit is maintained and ready for emergency use.

LPA reviewed three (3) staff files. LPA requested copies of Administrator certificates and liability insurance.

As of today's visit, no deficiencies were cited per California Code of Regulations, Title 22. Exit interview conducted copy of report given at the conclusion of this visit.
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Michael Hood
LICENSING EVALUATOR SIGNATURE: DATE: 01/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/22/2025
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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