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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 192000484
Report Date: 09/10/2021
Date Signed: 09/10/2021 10:45:34 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:CASTANEDA FAMILY CHILD CAREFACILITY NUMBER:
192000484
ADMINISTRATOR:CASTANEDA, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 962-2006
CITY:BALDWIN PARKSTATE: CAZIP CODE:
91706
CAPACITY:14CENSUS: 8DATE:
09/10/2021
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Maria CastanedaTIME COMPLETED:
11:00 AM
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On 9/10/21 Licensing Program Analyst (LPA), Fabiola Vasquez conducted a Case Management-Legal visit, LPA met with Licensee Maria Castaneda for the purpose to present the Decision and Order issued on 07/29/21 for a lifetime exclusion for Miguel Castaneda JR. (Licensee’s son).

Census was taken. Children 8 ( 3 of the children are infants) and Staff 2 were present.

LPA reviewed the D & O with licensee to confirm that licensee understands that Miguel Castaneda JR. has a lifetime exclusion from the facility, he is not to come to the facility at anytime. LPA provided a copy of the
D & O.

A copy of the report and Appeal rights were discussed and provided.

Notice of Site Visit was provided.

An exit interview was conducted with Licensee, Maria Castaneda on this date.

SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Fabiola VasquezTELEPHONE: (626) 361-1267
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2021
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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