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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197495103
Report Date: 07/13/2022
Date Signed: 09/29/2022 09:55:44 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/06/2022 and conducted by Evaluator Judy Laureano
PUBLIC
COMPLAINT CONTROL NUMBER: 30-CC-20220706110447
FACILITY NAME:CASTILLO FAMILY CHILD CAREFACILITY NUMBER:
197495103
ADMINISTRATOR:IRMA CASTILLOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 841-0852
CITY:BURBANKSTATE: CAZIP CODE:
91505
CAPACITY:14CENSUS: 4DATE:
07/13/2022
UNANNOUNCEDTIME BEGAN:
09:21 AM
MET WITH:Irma Castillo TIME COMPLETED:
10:00 AM
ALLEGATION(S):
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License: Licensee did not provide a written notice of intent to operate a Family Child Care Home to the landlord
INVESTIGATION FINDINGS:
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On 9/29/2022, Licensing Program Analyst (LPA) Judy Laueano arrived at this facility for the purpose of reviewing amended report to reflect correct LIC 9151 Landlord Notification.

On 7/13/2022, Licensing Program Analyst (LPA) Judy Laureano arrived at this facility for the purpose of investigating the allegation above. Upon arrival, LPA met with Licensee, Irma Castillo, and discussed the purpose of the inspection.

During this inspection, LPA interviewed the Licensee and obtained a copy of the LIC 9151 Landlord Notification. LPA observed 2 children in care.
Licensee has been a licensed childcare provider since 2004 with a license for a large family child care home since 2019. Licensee applied for a Change of Location on 4/1/2022. Upon processing the application, Licensee submitted the LIC 9151 Landlord Notification form to the El Segundo Regional Office. Licensee stated the landlord was aware of the intent to operate a family child care home prior to receiving licensure. Licensee stated she was not aware she needed to submit the form to the landlord. Licensee failed to provide landlord with written notification of LIC 9151. This interview was conducted in Spanish.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:

DATE: 09/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 30-CC-20220706110447
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: CASTILLO FAMILY CHILD CARE
FACILITY NUMBER: 197495103
VISIT DATE: 07/13/2022
NARRATIVE
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Based on observation, record review, and interviews with relevant parties, there a preponderance of evidence to prove the alleged violation did occur. Therefore, the allegation is SUBSTANTIATED. LPA Judy Laureano issued one Type B deficiency citation during today's inspection (see LIC 9099-D for details).

An exit interview was conducted and a copy of this report along with the Notice of Site Visit and Appeal Rights were provided to Licensee, Irma Castillo.
SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 30-CC-20220706110447
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: CASTILLO FAMILY CHILD CARE
FACILITY NUMBER: 197495103
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/13/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/13/2022
Section Cited
CCR
102417(p)(1)
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102417(p)(1)
(p) A prospective Family Child Care Home licensee who resides in a rental property shall ...(d) of the Health and Safety Code.The licensee shall maintain proof of this notification at the Family Child Care Home for review by the Department.(1)The licensee shall provide the landlord or owner of the rental property with...review by the Department. This requirement was not met as evidenced by:
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Licensee will mail the LIC 9151 Landlord Notification to landlord via certified mail by 7/15/2022 and will mail confirmation to LPA via email.
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Based on record review, observation and interview, the Licensee did not provide landlord with LIC9151 Landlord Notification, which poses a potential health, safety, or personal rights risk to 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.
SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:

DATE: 09/29/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 3