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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197418856
Report Date: 07/13/2021
Date Signed: 07/13/2021 01:52:46 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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:CASTELLON FAMILY CHILD CAREFACILITY NUMBER:
197418856
ADMINISTRATOR:CASTELLON, CAROLINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 294-5943
CITY:LOS ANGELESSTATE: CAZIP CODE:
90062
CAPACITY:14CENSUS: 8DATE:
07/13/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:24 AM
MET WITH:Carolina Castellon, LicenseeTIME COMPLETED:
02:00 PM
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Licensing Program Analysts (LPA) Alicia Mooberry conducted an Required Annual inspection to the above facility. Upon arrival, LPA met with licensee's 17 year old son who guided LPA to the back yard patio where LPA observed Noemi Martinez, (Staff 1) and Brenda Moreno (Staff 2) with 8 children in care. Carolina Castellon, Licensee, arrived at 11:30am and guided LPA on a tour of the home. This is a single story home, 3-bedrooms, 2-bathrooms, kitchen, living room, dining room, front yard and back yard (locked storage shed in the back yard). All adults present and are associated and fingerprint cleared. Licensee’s operating hours are Monday-Friday 7am-6:30pm.
Individuals who reside in the home were discussed and noted.

All areas identified on the facility sketch, including the areas that are off limits to children were inspected for safety, comfort, and cleanliness.

Off limit areas include 3 (three) bedrooms, one (1) bathroom (inside master bedroom) and front yard and side areas on both sides of the home and a storage shed in the back yard. LPA observed safety knobs on bedroom doors making bedrooms inaccessible to children in care.

Primary care is provided in the living room located in the front of the home. Children use the bathroom adjacent to the main care area. Hygiene products are kept in a bathroom cabinet secured with a safety lock. LPAs reminded the licensee that all products must be be inaccessible to children in care. The home has central air and heat. All furniture is neat, clean and in good repair. LPA observed age appropriate toys and learning materials for children. Children nap on mats in the main care area. Infant play yards are available in the living room for infants to nap in.
Per licensee, there is an area by the kitchen and living room that is used as isolation area if children are ill.
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SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia MooberryTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2021
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 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: CASTELLON FAMILY CHILD CARE
FACILITY NUMBER: 197418856
VISIT DATE: 07/13/2021
NARRATIVE
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There is telephone service via a cellphone that stays at the facility during operation hours.
LPA observed a fire place that is barricaded, per licensee, the fireplace gas line has been capped by the gas company and has not been used in years.

Detergents, cleaning compounds, medications, and other items which could pose a danger to children were observed to be inaccessible to children in locked kitchen cabinet under sink, in overhead cabinets over laundry area in the kitchen. The licensee has poisons and other chemicals in the storage shed in the back yard, observed to be locked with padlock.

LPA observed the required 2A 10BC fire extinguisher with service tag dated 6/17/21. Smoke and carbon monoxide detectors were tested and are operable.

The licensee has completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's Pediatric First Aid and CPR expired on 05/2022. There are first aid supplies available. LPA advised that if a child shows signs of illness they shall be separated from other children.

Children’s records were reviewed, including emergency information and all have the completed LIC 700 Identification and Emergency Information. The licensee is observed to be operating within the license capacity limitations.

The licensee and assistant have proof of immunization against influenza, pertussis, and measles. LPA observed that the Staff #2 and Licensee do not have proof of the Mandated Reporter AB 1207 Child Care Training Certificate on file. Per licensee, the training will be completed. LPA reminded licensee about the requirement for all licensed providers and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. Website: www.mandatedreporterca.com

The following was discussed:

  • All homes shall conduct fire and disaster drills at least once every six months, and document the date and time of each drill. The last drill conducted: 6/14/21
  • LPA did not observe any pools, spas, hot tubs, fish ponds, or similar bodies of water during the inspection.
  • Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted.
  • Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.
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SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia MooberryTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2021
LIC809 (FAS) - (06/04)
Page: 2 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: CASTELLON FAMILY CHILD CARE
FACILITY NUMBER: 197418856
VISIT DATE: 07/13/2021
NARRATIVE
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  • Individuals who are 18 years of age or older living in the home must obtain a criminal record clearance. Individuals within one month of their 18th birthday must be fingerprinted immediately. Failure to obtain a criminal record background check clearances prior to initial presence in the home will result in an immediate $100.00 dollar or more per day Civil Penalty.
  • In the absence of the licensee a qualified adult must be present supervising the children; a qualified adult is an individual who has a valid and current adult/infant CPR & Pediatric First Aid certification, TB clearance, immunization, and a valid criminal record clearance associated to the facility license.
  • Dog(s) and/or pets are recommended to be isolated from children in care. Licensee has no pets at the moment
  • No smoking, No infant walkers, No Johnny jumpers, No saucer chairs, No trampolines and any other item that falls into that category are not permitted in the facility.
  • LPA consulted and explained Child Abuse Reporting, Updated Patent’s Rights Poster with Complaint Hotline information, Never Shake a Baby, Sudden Infant Death Syndrome (SIDS), and Safe Sleeping practices which always Baby is sleeping on his/her back. The LIC 9227 Individual Infant Sleeping Plan shall be completed for each infant up to 12 months of age. LPA observed Licensee has copy of LIC 9227. Licensee states she doesn't have infants 12 months or younger enrolled.
  • Per licensee, there are no children enrolled that require IMS at this time. Incidental Medical Services (IMS) policy was discussed. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

LPA advised licensee on accessing forms and updated licensing information by going to: www.ccld.ca.gov

This facility is being cited today in accordance with Title 22 Regulations - See 809D.

Exit interview was conducted with Carolina Castellon, Licensee, including, but not limited to Appeal Procedures, Site Visit and Initial Appeal Rights.

SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia MooberryTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2021
LIC809 (FAS) - (06/04)
Page: 3 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: CASTELLON FAMILY CHILD CARE
FACILITY NUMBER: 197418856
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/13/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/20/2021
Section Cited

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a person who applies for a license to be a provider of a child day care facility...shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.
This requirement is not met as evidenced by:
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Per record reviews and Licensee confirming. Licenee and staff #2 did not completed the Mandated Reporter training in a timely manner

This poses a potential risk to the health and safety of children in care.
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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: Valarie CookTELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia MooberryTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 07/13/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/13/2021
LIC809 (FAS) - (06/04)
Page: 4 of 4