374604839-1-15-2025-08-AS-LSIA-DCXQUS-20250115112910

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 374604839
Report Date: 01/14/2025
Date Signed: 01/15/2025 11:29:40 AM

Document Has Been Signed on 01/15/2025 11:29 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
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME:	CASA DE CASTRO III		FACILITY NUMBER:	374604839
ADMINISTRATOR/ DIRECTOR:	CASTRO, CELESTE & CHERYL		FACILITY TYPE:	740
ADDRESS:	319 S SIENA ST		TELEPHONE:	(619) 857-6945
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92114
CAPACITY: 8		CENSUS: 0	DATE:	01/14/2025
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:15 AM
MET WITH:	Licensee Cheryl Castro and Administrator Celeste Castro		TIME VISIT/ INSPECTION COMPLETED:	01:00 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

Licensing Program Analyst (LPA) Liliana Silveira conducted an announced Pre-Licensing visit to observe the facility’s physical plant for compliance with Title 22, Division 6 of the California Code of Regulations and California Health & Safety Code. LPA was greeted by, identified herself to, and explained the purpose of the visit with Licensee Cheryl Castro and Administrator Celeste Castro.

The facility fire clearance was granted on 08/26/24 and reflected that the facility was approved for six (6) non-ambulatory residents, 60 years or age or older. The facility's fire clearance did not include delayed-egress door or secured perimeter endorsements, and neither were present during today's visit. The submitted facility sketch was consistent with the current layout of the facility.

During today’s visit, LPA, accompanied by Cheryl and Celeste, toured the interior and exterior of the facility and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were well lit and free of obstruction and slip hazards. Resident bedrooms allowed for easy passage and contained the required furnishings. Toilets, sinks, and showers were in working order. The facility’s ambient internal temperature was compliant at 68 degrees F. Hot water temperature at taps accessible to residents were also compliant: Kitchen sink was 117.5 F, Bathroom #1 sink was 117.6 F, and Bathroom #2 sink was 117.4 F.

The facility has enough linens, hygiene supplies, cooking and dining supplies, and food for future resident use. All kitchen appliances were in working order.

The facility has sufficient space and equipment to facilitate laundry, visitation, meetings, and resident activities. The facility has locked areas for storage of sharp objects, medication, and confidential resident and staff records. (CONTINUED ON NEXT PAGE, LIC 809-C)

SUPERVISORS NAME: Robyn Clark
LICENSING EVALUATOR NAME: Liliana Silveira
LICENSING EVALUATOR SIGNATURE:	DATE: 01/14/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2025

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
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: CASA DE CASTRO III	FACILITY NUMBER: 374604839
	VISIT DATE: 01/14/2025

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

(CONTINUED FROM FIRST PAGE, LIC 809) No pools or bodies of water were observed on the premises. There were no toxic chemicals/poisons, fireplaces, or open-faced heaters accessible to residents. Per Administrator, no firearms or ammunition are or will be stored at the facility.

Smoke alarms, carbon monoxide detectors, emergency lighting, and facility telephone were all operational. All fire extinguisher(s) were serviced within the last twelve months. A complete first aid kit was present. Required licensing postings were observed in visible areas of the facility.

LPA also presented and discussed the Component III Training during today’s visit.

The items reviewed were complaint with Title 22, Division 6 of the California Code of Regulations and California Health & Safety Code. The applicant passed the pre-licensing inspection. Cheryl and Celeste were advised that the facility’s application is pending management final review and approval.

An exit interview was conducted with the Cheryl and Celeste, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided. Signature below confirms receipt of the documents.

SUPERVISORS NAME: Robyn Clark
LICENSING EVALUATOR NAME: Liliana Silveira
LICENSING EVALUATOR SIGNATURE:	DATE: 01/14/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2025

LIC809 (FAS) - (06/04)

Page: 2 of 2