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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 192000484
Report Date: 12/20/2021
Date Signed: 12/20/2021 02:46:23 PM

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: 6DATE:
12/20/2021
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Maria CastanedaTIME COMPLETED:
03:00 PM
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On 12/20/21 Licensing Program Analyst (LPA) Fabiola Vasquez conducted an unannounced Case Management- Legal visit. LPA met with licensee Maria Castaneda for the purpose of finalizing that she received the Decision and Order of her son Miguel Castaneda Jr. That parents received and signed the LIC 9224 Acknowledgement of receipt of licensing reports along with a copy of the Decision and Order.

Census was taken: Children 6 ( 1 being an infants) and Staff 2 were present.

LPA observed copies of the 9224 Acknowledgement of receipt of licensing reports with the parents signatures dated 5/7/21 in the children's file. Per license she also provided parents with a copy of the Decision and Order.

Licensee cares for her granddaughter. A declaration was obtained from licensee stating that her son Miguel Castaneda Jr does not come to the facility to pick up his daughter.

Notice of Site Visit was provided.

Exit interview conducted with Licensee, Maria Castaneda a copy of the report and Appeal rights were discussed and provided.

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

DATE: 12/20/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2021
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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