Ashton Home

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Evelin Rios arrived to the facility above to conduct an unannounced annual required visit. LPA was greeted by a caregiver and granted access. Caregiver contacted the Licensee representative, Isaias Yin to inform him LPA was at the facility and the reason for the visit. Isaias informed LPA they would not be able to meet with LPA but would be available by telephone. At 9:30am LPA conducted a tour of the physical plant and observed the following: The facility is licensed for a capacity of six (6) residents. The fire clearance is approved for one (1) ambulatory resident in room #1, four (4) non-ambulatory residents in rooms #4, #5, #6, and one (1) bedridden resident in room #3. Room #4 can be shared. The facility also has a waiver granted for hospice care of two (2) residents. At entry LPA observed a sign in sheet for visitors, thermometer, hand sanitizer and PPE supplies. LPA observed required posting through out the facility. The formal dining table sits the capacity of the facility and is in good repair. The facility keeps resident and staff records in a filing cabinet in the formal dining area. In the kitchen LPA observed there to be a sufficient supply of two-day perishable and seven-day non-perishable foods in the facility. The facility has the overflow of food stored in a second refrigerator and freezer in the garage. Food storage and preparation areas are clean and inaccessible to pests. The fire extinguisher is located in the kitchen and was last serviced on 01/07/2026. The medication and sharps were observed locked in kitchen cabinets. LPA observed a a small locked refrigerator on the kitchen counter used to store medication requiring refrigeration. LPA observed a second dining table with chairs. The living room has a television and recliners for residents. Doors leading to the outside have auditory alarms that were functioning properly. (Continue to LIC809-C) In the hallway LPA observed the thermostat that read 73°F and night lights leading to bathrooms. The five (5) resident Bedrooms are appropriately furnished and have appropriate lighting. Bathrooms were appropriately supplied with hand soap, toilet paper and paper towels. Extra towels and linens were readily available in a hallway closet. The hot water temperature in two (2) out of three (3) bathrooms measured 114.6°F and 116.6°F, within regulation. The laundry room was observed locked and leads to the attached garage. All chemicals and detergents are kept in the laundry room inaccessible to residents in care. The backyard is fenced in, and LPA observed appropriate outdoor furniture, with covered shaded areas for residents. Dual smoke/carbon monoxide alarms were tested at 12:50 PM and observed to be operational. LPA reviewed three (3) of three (3) resident records. Three (3) of three (3) resident records were incomplete. Two (2) of three (3) resident files were missing copies of admission agreements. Three (3) of three (3) resident files were missing copies of resident appraisals. Resident #1 (R1) does not have a medical assessment on file. Centrally stored medication and medication records were reviewed fro proper documentation. LPA reviewed two (2) staff files. Staff stated they had completed training but facility did not have orientation or staff training documentation. One (1) of two (2) staff did not have a health screening with TB results or first aid certification on file. LPA was not provided documentation that emergency drills were conducted quarterly by facility staff. Last documented drill was conducted 03/25/2025. LPA requested copies of the Certificate of Liability Insurance and Emergency Disaster Plan (LIC610E) be emailed to LPA. Citations issued on LIC809-D during this visit. Exit interview conducted. Appeal rights and a copy of this report provided to caregiver.the state’s words, verbatim · CDSS document, May 22, 2026

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Evelin Rios initiated a Case Management – Deficiencies visit. LPA arrived to the facility and was greeted and granted access by caregiver. Caregiver contacted the Licensee representative, Isaias Yin and LPA explained that the purpose of the visit was to discuss information received by Community Care Licensing Division (CCLD) regarding the potential sale of the facility. On 03/09/2026, the Department received a report indicating that the licensee had accepted a down payment toward the sale of the facility in December 2025. LPA Rios spoke with the licensee’s representative, Isaias Yin, on 03/09/2026 who stated, that an offer had been accepted and that the prospective new owner was expected to begin integrating into facility operations in January or February of this year. However, the buyers later decided not to proceed with the purchase. The licensee representative also confirmed that neither the residents nor their responsible parties had been notified in writing of the accepted offer. Additionally, the Department had not been informed that the facility had entered into an agreement to sell. Although the sale is no longer moving forward, the facility failed to provide written notice to the Department and to each resident or their legal representative of the licensee’s intent to sell the facility at least 30 days prior to the transfer of property or business, or at the time a bona fide offer was made, whichever period is longer. At this time the facility is not considering an offer. No health or safety concerns were observed during the visit. Deficiency cited on LIC809-D. Exit interview conducted. Appeal Rights provided. Copy of report provided to Marialinda.the state’s words, verbatim · CDSS document, Apr 10, 2026

From the deficiency page — Deficiency type: Type B · Section cited: HSC 1569.191 · Plan of correction due date: Apr 17, 2026

(a)... in the event of a sale... (1) The licensee shall provide written notice to the department and to each resident or his or her legal representative of the licensee's intent to sell the facility at least 30 days prior to the transfer of the property or business, or at the time that a bona fide offer is made, whichever period is longer. This requirement is not met as evidence by: Based on interviews the facility accepted an offer and did not notify the department or residents in writing which poses a potential risk to the health, safety or personal rights of residents in care.the state’s words, verbatim · CDSS document, Apr 10, 2026

Plan of correction: The facility is no longer moving forward with the sale. The licensee agrees to provide the Department with a written statement acknowledging the Health and Safety Code sections cited, along with an explanation of how compliance will be ensured moving forward, by the POC due date.

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Evelin Rios conducted a Pre-Licensing Inspection with the applicant representative / administrator, Phil Zhou and administrator designee Kazeem Abass. The applicant is"ASHTON HOME LLC". This is a Change in Ownership "CHOW" application. A fire clearance was approved on 10/23/24 for six (6) non-ambulatory residents, one (1) of which may be bedridden in Room #3. The facility has a total of six (6) bedrooms and three (3) bathrooms. A tour of the physical plant was initiated at approximately 9:15 AM and the following was observed: KITCHEN: The facility has a Kitchen that is equipped with a refrigerator, microwave, stove, dishwasher and sink. There was an adequate supply of perishable and nonperishable food. Knives were observed locked in a kitchen cabinet. Cleaning supplies and other toxins were observed locked under the kitchen sink cabinet. BEDROOMS: There are five (5) bedrooms designated for residents use; four (4) private and one (1) shared. The bedrooms are furnished with beds, night stand, chairs, dressers, bedding and appropriate linens. The bedrooms have sufficient lighting and storage. BATHROOMS: The facility has three (3) bathrooms; one (1) is located in the shared bedroom. The bathrooms were observed to have the proper fixtures, grab bars, and non-skid mats. The hot water temperature was measured at 118.4°F, within regulation. LAUNDRY ROOM: The laundry room leads to the garage and is maintained locked. Laundry detergents and other cleaning agents were locked in a cabinets inside the laundry room. The garage was observed to be locked during visit. The facility keeps a second refrigerator and a freezer. (Continued on LIC 809-C) (continued from LIC 809) COMMON AREAS: These included the living room and the dining area. Living room was furnished with chairs and side tables. The living room area was furnished with a television, recliners and chairs that sit the capacity of the facility. There were no visible immediate hazards. There is a working telephone line and internet accessible to residents. Dual smoke/carbon monoxide alarms were tested at 10:15 AM and observed to be operational. Fire extinguisher was observed fully charged with service date of 01/09/25. MEDICATIONS: The medication cabinet is located in the kitchen and has a locking mechanism. Two first aid kits with manual were observed inside a hallway cabinet. LPA reviewed centrally stored medication records. Staff/Resident Records: Staff and resident records are kept locked in a filing cabinet. LPA reviewed resident and staff records for compliance. SURROUNDING GROUNDS: The driveway, passageways and entrance to the home was clear of obstruction. All entry and exit doors have a functional auditory alarms when the doors open. The backyard of the facility has two covered patios and backyard furniture to accommodate the residents. There are no bodies of water. Component III was conducted with the Administrator /Licensee Representative and Administrator designee. No deficiencies were observed during visit. This report will be sent to Centralized Application Bureau (CAB). You will be notified by the CAB Analyst when the license has been approved. You are not allowed to begin operating until you have been notified that your license has been approved by the CAB Analyst. Failure to comply could affect approval of your license. Exit interview conducted. Copy of this report issued.the state’s words, verbatim · CDSS document, Apr 28, 2025