434410255-7-30-2021-07-CC-JGSS-C5ESHU-20210730135406

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434410255
Report Date: 07/30/2021
Date Signed: 07/30/2021 01:54:13 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	CASTRENCE, GAIL		FACILITY NUMBER:	434410255
ADMINISTRATOR:	CASTRENCE, GAIL		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(408) 712-5447
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95148
CAPACITY:	14	CENSUS: 0	DATE:	07/30/2021
TYPE OF VISIT:	Case Management - Other	ANNOUNCED	TIME BEGAN:	11:15 AM
MET WITH:	Gail Castrence, Licensee		TIME COMPLETED:	02:05 PM

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	Licensing Program Analyst (LPA), James Santos conducted an announced visit today and met with Licensee, Gail Castrence. The day care home has been inactive since August 2019 due to water damage. The purpose of the visit is to inspect the home for compliance which includes physical plant and personnel records review. Licensee is planning to open her day care home starting August 9, 2021. Gail and husband, Larry, and their 2 children who are 19 and 22 years old are the adults that live in the home and with their 2 other children ages 12 and 15 years old. Days and hours of operation are M-F , 7:30AM to 5:30 PM. LPA toured the indoor and outdoor areas of the home with the Licensee during today's visit. Off limit areas inside the home include the garage, 2nd floor of the house, kitchen and laundry room. Off limit areas outside the home include the 2 fenced side yards and upper level patio area in the back yard. The home is clean and well maintained. LPA observed barricaded stairs and fenced fire place inside the home. The home has a fully charged fire extinguisher, functioning smoke and carbon monoxide detector, and first aid kit. Licensee stated that they do not have any weapons, ammunition or poison in the home. Chemicals and cleaning compounds, medications and other items which could pose danger to children are secured and inaccessible to children. Licensee has a pet dog, Labradoodle that is vaccinated and kept in off limit areas during day care hours. There are sufficient materials, toys and play equipment that are age appropriate for the day care children. Licensee and staff records reviewed include Criminal Record, TB Clearance, Immunization (Measles, Pertussis, and Flu) record, CPR/First Aid and Mandated Reported Training. Continued on next page.

SUPERVISOR'S NAME: Anthony Studebaker	TELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: James G Santos	TELEPHONE: (408) 334-8556
LICENSING EVALUATOR SIGNATURE:	DATE: 07/30/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2021

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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: CASTRENCE, GAIL	FACILITY NUMBER: 434410255
	VISIT DATE: 07/30/2021

NARRATIVE

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LPA reminded Licensee of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the license and who come in contact with or provide care and supervision to the children. For an initial violation, civil penalty amounts to $100.00 per person per day up to $500.00 per person. For a subsequent violation within a 12-month period, civil penalty amounts to $100.00 per person per day up to $3000.00 per person.

LPA reviewed with Licensee the violations that would result in an immediate assessment of civil penalty in the amount of $500. Licensees are encouraged to visit the Department’s website at www.cdss.ca.gov [Shortcut: www.ccld.ca.gov] to access resources for Providers, Regulations, Adoptions of new laws, pay annual fees etc.

Beginning January 1, 2019 AB2370 requires licensed homes and centers to share information on the risks and effects of lead exposure with enrolling and re-enrolling families. LPA discussed with licensee the Lead Poisoning Facts Information and Safe Sleep Regulations (PIN 20-24-CCP).

Licensee stated that she is not planning to provide (Incidental Medical Services) IMS at this time.

No deficiencies cited during today's inspection. A copy of this report was provided to the Licensee.

The day care home's license will be placed back into active status and an updated license will be mailed to Licensee.

A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE ENTRANCE TO THE FACILITY, AND MUST REMAIN POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Anthony Studebaker	TELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: James G Santos	TELEPHONE: (408) 334-8556
LICENSING EVALUATOR SIGNATURE:	DATE: 07/30/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2021

LIC809 (FAS) - (06/04)

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