<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197416779
Report Date: 04/18/2024
Date Signed: 04/18/2024 12:26:20 PM


Document Has Been Signed on 04/18/2024 12:26 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 IN THE CLOUDSFACILITY NUMBER:
197416779
ADMINISTRATOR:LEE, KYE J.FACILITY TYPE:
850
ADDRESS:1435 W. 120TH STREETTELEPHONE:
(323) 756-9191
CITY:LOS ANGELESSTATE: CAZIP CODE:
90047
CAPACITY:50CENSUS: 6DATE:
04/18/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Candyce Lee, AdminstratorTIME COMPLETED:
10:00 AM
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
On 04/18/2024, Licensing Program Analyst Adrian Risher conducted a case management inspection to cite deficiencies regarding the Stipulation, Waiver and Order dated 09/08/2023. LPA met with Candyce Lee, Administrator's assistant. LPA observed 6 children in care with 3 staff.

Licensees were to ensure that all staff obtained a current Pediatric First Aid and CPR by 11/07/2023.
Based on file review conducted on 02/09/2024, there was not a current Pediatric First Aid and CPR certification on file for all staff. This poses a potential risk to the health and safety of the children in care. The facility is being issued a Type B violation under Personnel Records.

Facility is required to provide quarterly financial plans by 01/15/2024. Licensee did not provide financial plan to the Licensing Regional Office by 01/15/2024 which poses a potential risk to the health and safety of the children in care. The facility is being issued a Type B violation under Financial Plan. The financial plan was provided to LPA Keyona Scott on 02/14/2024 via email. Therefore, this Type B violation will be cleared.

Facility was required to provide the 2nd quarter financial plan for 2024 0by4/15/2024. The facility has not provided the quarterly financial plan as of 04/18/2024 which poses a potential risk to the health and safety of the children in care. The facility is being issued a Type B violation under Financial Plan.

Exit interview was conducted and a copy of the report was provided. Appeal rights were reviewed and provided.

SUPERVISOR'S NAME: Maureen NealTELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Adrian RisherTELEPHONE: (424) 301-3050
LICENSING EVALUATOR SIGNATURE:
DATE: 04/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/18/2024
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 3


Document Has Been Signed on 04/18/2024 12:26 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 IN THE CLOUDS
FACILITY NUMBER: 197416779

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/18/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/17/2024
Section Cited

2D

1
2
3
4
5
6
7

Per Stipulation, Waiver, and Order dated 09/08/2023- Personnel Records: Respondents shall maintain current… ensure that all employees have current certificate of CPR and First Aid training on file... This requirement was not met as evidenced by:
1
2
3
4
5
6
7

Licensee will ensure all staff register for Pediatric CPR and First Aid training within three (3) business days, no later than 04/22/2024 and provide proof of completion within 30 days, no later than 05/17/2024.
8
9
10
11
12
13
14

Based on file review, five(5) out of eight(8) staff did not provide proof of completion of Pediatric CPR and First Aid; which poses a potential Health & Safety Risk to children in care.
8
9
10
11
12
13
14
Type B
04/18/2024
Section Cited
2O

1
2
3
4
5
6
7

Per Stipulation, Waiver, and Order dated 09/08/2023- Financial Plan: Respondents shall develop and comply with a financial plan… shall be submitted to Licensing on a quarterly basis. This requirement was not met as evidenced by:
1
2
3
4
5
6
7

On 02/12/2024, LPA Keyona Scott contacted Licensee to inquire about status of financial plan and requested to submit financial plan by 02/14/2024 close of business. Licensee submitted financial plan to LPA Scott on 02/14/2024.
8
9
10
11
12
13
14

Based on record review, Licensee did not provide financial plan to the Licensing Regional Office by 01/15/2024; which poses a potential health and safety risk to the child(ren) in care.
8
9
10
11
12
13
14
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: Maureen NealTELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Adrian RisherTELEPHONE: (424) 301-3050
LICENSING EVALUATOR SIGNATURE:
DATE: 04/18/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/18/2024
LIC809 (FAS) - (06/04)
Page: 2 of 3


Document Has Been Signed on 04/18/2024 12:26 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 IN THE CLOUDS
FACILITY NUMBER: 197416779

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/18/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/02/2024
Section Cited

2O

1
2
3
4
5
6
7
Per Stipulation, Waiver, and Order dated 09/08/2023- Financial Plan: Respondents shall develop and comply with a financial plan… shall be submitted to Licensing on a quarterly basis. This requirement was not met as evidenced by:
1
2
3
4
5
6
7
Licensees will provide the quarterly financial plan to LPA no later than 05/02/2024.
8
9
10
11
12
13
14
Based on record review, Licensee did not provide financial plan to the Licensing Regional Office by 04/15/2024; which poses a potential health and safety risk to the child(ren) in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Maureen NealTELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Adrian RisherTELEPHONE: (424) 301-3050
LICENSING EVALUATOR SIGNATURE:
DATE: 04/18/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/18/2024
LIC809 (FAS) - (06/04)
Page: 3 of 3