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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197408481
Report Date: 06/08/2022
Date Signed: 06/08/2022 03:10:42 PM


Document Has Been Signed on 06/08/2022 03:10 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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245



FACILITY NAME:CASTLE OAKS CHILDREN'S CENTERFACILITY NUMBER:
197408481
ADMINISTRATOR:MARIA R. GRANADOSFACILITY TYPE:
850
ADDRESS:6739 CORBIN AVENUETELEPHONE:
(818) 881-7333
CITY:CANOGA PARKSTATE: CAZIP CODE:
91306
CAPACITY:44CENSUS: 22DATE:
06/08/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:58 AM
MET WITH:Forcila Lim, DirectorTIME COMPLETED:
03:15 PM
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On 6/08/2022 at 9:00 am Licensing Program Analyst (LPA) Deborah Lowe, conducted an unannounced Annual Required Inspection for the preschool license. LPA Lowe was greeted by S#3 at the gate. LPA met with Director, Forcila Lim, and toured the facility indoors and outdoors. Days and hours of operation are Monday – Friday 6:30 am – 6:00 pm.

At 9:12 am LPA Lowe observed 17 children outside in care and supervision of 3 teachers. At 9:54 am LPA conducted another count of children due to the observation of more children arriving. At 9:54 am LPA observed 22 children in care and supervision of 3 teachers.

There is no swimming pool or other bodies of water on the premises. Disinfectants, cleaning solutions, medication and other hazardous items are made inaccessible. No poisons were observed during the inspection.

Furniture and equipment are in good condition, free of sharp, loose or pointed parts.

Playground equipment is in need of repair. At 9:29 am LPA observed the large pumpkin shaped play equipment in outdoor play area to be with chipped and pealing paint at the base accessible to children. LPA Lowe advised per CCR 101239(o)(1): (o) Playground equipment shall be securely anchored to the ground unless it is portable by design. (1) Equipment shall be maintained in a safe condition, free of sharp, loose or pointed parts.

The surface of the outdoor activity space is need of cleaning and repair. At 9:26 am LPA Lowe observed the surface of the outdoor area foam material used to absorb falls is cracked and breaking away located near pumpkin shaped equipment and under metal play equipment of train and cars. LPA Lowe observed debris of trash and loose concrete around the base of the wall. LPA Lowe advised per CCR 101238.2(d)(2) (d) The surface of the outdoor activity space shall be maintained: (2) Free of hazards including, but not limited to, holes, broken glass and other debris, and dry grasses that pose a fire hazard.

SUPERVISOR'S NAME: Lisa RiosTELEPHONE: (424) 301-3072
LICENSING EVALUATOR NAME: Deborah LoweTELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:
DATE: 06/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/08/2022
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: CASTLE OAKS CHILDREN'S CENTER
FACILITY NUMBER: 197408481
VISIT DATE: 06/08/2022
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The Director advised LPA facility has received bids to redo outdoor play area. LPA advised while facility is waiting to redo outdoor play area, the area and equipment still needs to be maintained in a safe condition.

All toilets and handwashing facilities are in safe and sanitary operating condition. Floors in the facility are clean and safe.

Kitchen and storage area is clean, free of litter/rubbish and free of rodents/vermin. Facility does not prepare food at this location. Food for the children is delivered from an outside source. Families have the option to bring food from home or have the food that is delivered to the facility. Solid waste storage containers have tight-fitting covers and are in good repair. Drinking water is available both indoors and outdoors.

Areas around high climbing equipment, swings and slides have cushioning material to absorb falls. LPA observed the area of the foam material that absorbs falls under the swing area to be in good and safe condition. The facility is free of flies, insects and rodents. Facility has one functioning carbon monoxide detector and LPA Lowe was able to hear a successful test.

Capacity and limitations as specified on the license are being maintained. At least one person trained in CPR and Pediatric First Aid is present when children are at the facility or at offsite activities.

At 12:23 pm LPA reviewed sign in/out sheets and found 9 out of 22 children in attendance to be missing signatures for am drop off on 6/08/2022 and missing signatures from past days of attendance. LPA Lowe advised per CCR 101229.1(b): (b) The person who brings the child to, and removes the child from, the center shall sign the child in/out.

All children are under supervision, including visual supervision, of a teacher at all times. Facility maintains a ratio of one teacher supervising no more than 12 children in care. LPA provided consultation and advised using zones for placement of staff to assist staff with supervision of outdoor area, classroom doors, and bathrooms.

LPA reviewed a sample of children’s files and observed files were complete with contact information for authorized representative and or relatives or others who can assume responsibility for the child and medical assessment. LPA reviewed staff files of staff who were present during visit and observed files were complete with health screening, immunization records for influenza, pertussis and measles and current documentation

SUPERVISOR'S NAME: Lisa RiosTELEPHONE: (424) 301-3072
LICENSING EVALUATOR NAME: Deborah LoweTELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:

DATE: 06/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/08/2022
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: CASTLE OAKS CHILDREN'S CENTER
FACILITY NUMBER: 197408481
VISIT DATE: 06/08/2022
NARRATIVE
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of completed mandated reporter training. Menus are posted at least one week in advance where an authorized representative can view them.

Incidental Medical Services (IMS) are not currently being provided. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.


To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Facility representative was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed facility representative of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiencies are being cited: (see next page, 809 D). Licensee was provided a copy of their appeal rights.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the Facility representative Forcila Lim, Director.

SUPERVISOR'S NAME: Lisa RiosTELEPHONE: (424) 301-3072
LICENSING EVALUATOR NAME: Deborah LoweTELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:

DATE: 06/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/08/2022
LIC809 (FAS) - (06/04)
Page: 3 of 9
Document Has Been Signed on 06/08/2022 03:10 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245


FACILITY NAME: CASTLE OAKS CHILDREN'S CENTER

FACILITY NUMBER: 197408481

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 06/08/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101238.2(d)(2)
Outdoor Activity Space
(d) The surface of the outdoor activity space shall be maintained: (2) Free of hazards including, but not limited to, holes, broken glass and other debris, and dry grasses that pose a fire hazard.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
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4
Based on observation and interview, the licensee did not comply with the section cited above in LPA Lowe observed the surface of the outdoor area foam material used to absorb falls is cracked and breaking away located near pumpkin shaped equipment and under metal play equipment of train and cars. LPA Lowe observed debris of trash and loose concreate around the base of the wall. which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/24/2022
Plan of Correction
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Director stated after speaking with the owner they have decided to remove the foam material to absorb falls located near pumpkin shaped equipment and under metal play equipment of train and cars and replace with different material. Director will send LPA Lowe pictures once compelted on or before 6/24/2022.
Type B
Section Cited
CCR
101239(o)(1)
Fixtures, Furniture, Equipment and Supplies
(o) Playground equipment shall be securely anchored to the ground unless it is portable by design. (1) Equipment shall be maintained in a safe condition, free of sharp, loose or pointed parts.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above in LPA observed the large pumpkin shaped play equipment in outdoor play area to be with chipped and pealing paint at the base accessible to children. which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/24/2022
Plan of Correction
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3
4
Director stated after speaking with the owner they have decided to remove the pumpkin shaped play equipment. Director will send LPA Lowe pictures once compelted on or before 6/24/2022.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Lisa RiosTELEPHONE: (424) 301-3072
LICENSING EVALUATOR NAME: Deborah LoweTELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:
DATE: 06/08/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/08/2022
LIC809 (FAS) - (06/04)
Page: 4 of 9


Document Has Been Signed on 06/08/2022 03:10 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245


FACILITY NAME: CASTLE OAKS CHILDREN'S CENTER

FACILITY NUMBER: 197408481

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 06/08/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101229.1(b)
Sign In and Sign Out
(b) The person who brings the child to, and removes the child from, the center shall sign the child in/out.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in 9 out of 22 children in attendance to be missing signatures for am drop off on 6/08/2022 and missing signatures from past days of attendance which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/17/2022
Plan of Correction
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Director will provide letter to parents expressing the importance and regulation that all children shall be signed in/ out daily with use of full signature. Director will submitt a declaration of understanding and communication with staff about sign in/ out policy. Director will email declaration and letter provided to parents on or before 6/17/2022.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Lisa RiosTELEPHONE: (424) 301-3072
LICENSING EVALUATOR NAME: Deborah LoweTELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:
DATE: 06/08/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/08/2022
LIC809 (FAS) - (06/04)
Page: 5 of 9