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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198008757
Report Date: 04/19/2023
Date Signed: 04/19/2023 11:46:37 AM


Document Has Been Signed on 04/19/2023 11:46 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754



FACILITY NAME:CASTELLANOS FAMILY CHILD CAREFACILITY NUMBER:
198008757
ADMINISTRATOR:CASTELLANOS, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 638-1157
CITY:LYNWOODSTATE: CAZIP CODE:
90262
CAPACITY:14CENSUS: 0DATE:
04/19/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:20 AM
MET WITH:Maria Castellanos, LicenseeTIME COMPLETED:
12:15 PM
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On 04/19/2023 at 10:20 AM, Licensing Program Analyst (LPA)Katrina Chicote conducted an Unannounced Required – 1 Year inspection to the above facility. Upon arrival, LPA disclosed the purpose of the inspection and met with Licensee, Maria Castellanos, who guided the LPA on a tour of the facility. Adults in the home were discussed and all have criminal record clearance. There were no day care children present during today’s inspection. Licensee states that there are currently three children enrolled. The children's roster was reviewed and is current. Required postings were observed during inspection. Disaster drill log was also available during today’s inspection, last disaster drill conducted on 03/29/2023.

This is a two-story home which consists of three bedrooms and 2.5 bathrooms, Kitchen, Living Room, Daycare Room, and attached garage. Areas used by the children include the Living Room (located upon entry), Dining Room (located next to Living Room), half bathroom (located next to Dining Room), and Daycare Room (located to the left rear of the home). Per Licensee, areas off limits to children and parents include entire upstairs which contain bedrooms and two bathrooms and Kitchen. LPA observed that there is an operable baby gate at bottom of steps making upstairs off limits and a door with Kitchen lock making it off limits at time of inspection.

All areas identified on the facility sketch as accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for the safety of the children. There is a working telephone maintained in the home. At 10:20 AM, LPA observed Living Roo to have child size table and chairs in the middle of Living Room and couches available for children. Per Licensee, this area is currently being used by children for dining and activity space as Daycare Room is being cleaned and painted. At 10:27 AM, LPA observed Daycare Room to be blocked off by accordian gate and observed observed dolls, plastic toys, and other age appropriate toys, free of loose and sharp parts available. LPA observed Daycare Room to have toys to the side and plastic coverings on walls confirming Licensee's statement that area is currently being
Report continues- Page 1 of 3
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Katrina ChicoteTELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:
DATE: 04/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/19/2023
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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: CASTELLANOS FAMILY CHILD CARE
FACILITY NUMBER: 198008757
VISIT DATE: 04/19/2023
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cleaned and painted. Detergents, cleaning compounds, medications, and other items which can pose a danger to children are inaccessible. Licensee states these items are stored in off limits Kitchen area, LPA observed these items to be in Kitchen at time of inspection. At 10:33 AM, LPA observed half bathroom that children use to have operable toilet and sink, adequate hand washing and toileting supplies, and a wall diaper changing table available. LPA observed an operable child safety lock on under cabinet sink at time of inspection. Per Licensee, all medicines are stored in her off limits bedroom upstairs in a locked cabinet. The Licensee was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care.

Per Licensee, the children will have access to backyard area for outdoor play. At 10:40 AM, LPA observed backyard to be accessible through front door and walking on sidewalk to access side gate. LPA observed outdoor play area has concrete and adequate perimeter fencing through-out the yard. At 10:42 AM, LPA observed corner area of backyard to have an area with stacked cushioning pads stacked high and metal poles leaning against a wall which has not been made off limits and is only blocked off by caution tape. LPA discussed observation with Licensee. LPA observed plastic ride along toys, plastic play houses, and other age appropriate toys free of loose and sharp parts available for the children in the outdoor play area.

Per Licensee, they provide food for children in care and are currently using Living Room to eat. LPA observed child appropriate tables and chairs for eating. Licensee states Living Room will also serve as isolation area for sick children. LPA observed a small dog in the home during inspection.

At 10:24 AM, LPA observed the valve on the required 2A 10BC fire extinguisher indicates fully charged with service tag dated 04/05/2023. LPA tested smoke and carbon monoxide detectors and observed to be in operable condition at time of inspection. LPA observed First Aid kit available in Daycare Room. The Licensee has current Pediatric First Aid and CPR. Proof of immunization against influenza, pertussis, and measles was readily available during today’s inspection. The Licensee has also taken the Mandated Reporter Training
—CPR Card valid until: 01/27/2024
—Mandated Reporter AB1207 Completed: 04/07/2023

Per Licensee, there are no weapons, firearms in the home and there are no bodies of water around the premises. LPA observation did not see any bodies of water around the premises or firearms at time of inspection. Report Continues - Page 2 of 3
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Katrina ChicoteTELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:

DATE: 04/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2023
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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: CASTELLANOS FAMILY CHILD CARE
FACILITY NUMBER: 198008757
VISIT DATE: 04/19/2023
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The following were discussed:
Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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

Licensee (or facility representative) was reminded that all adults 18 and over living or working in the home, 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 licensed Family Child Care Home. 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.

Rooms that are off-limits need to be made inaccessible during operating hours. NO smoking, NO infant walkers, NO Johnny jumpers, NO saucer chairs, NO incline sleepers and any other item that falls into that category are permitted in the facility.



LPA discussed the safe sleep regulations with licensee 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 licensee 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.

The following deficiencies on the attached LIC 809D are being cited. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site inspection by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00. Exit interview was conducted and report was reviewed with the Licensee, Maria Castellanos. Report Ends - Page 3 of 3

SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Katrina ChicoteTELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:

DATE: 04/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2023
LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 04/19/2023 11:46 AM - 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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754


FACILITY NAME: CASTELLANOS FAMILY CHILD CARE
FACILITY NUMBER: 198008757

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/19/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA observation LPA did not observe the above regulation to be met. LPA observed area of outdoor play area to have cushioning pads to be stacked high and large metal poles leaning against wall area is only blocked off by caution tape but has not been made inaccessible to children. This poses a potential health, safety, and personal rights risk to children in care.
POC Due Date: 05/19/2023
Plan of Correction
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Licensee states she will clean area and remove items observed and provide photos to LPA via email by POC date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: Karen ChambersTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Katrina ChicoteTELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:
DATE: 04/19/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/19/2023
LIC809 (FAS) - (06/04)
Page: 4 of 4