444410958-5-14-2024-07-CC-TTRO-D59VAE-20240514161548

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 444410958
Report Date: 05/14/2024
Date Signed: 05/14/2024 04:16:26 PM

Document Has Been Signed on 05/14/2024 04:16 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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	CASTILLO, MARIA		FACILITY NUMBER:	444410958
ADMINISTRATOR:	CASTILLO, MARIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(831) 761-2401
CITY:	WATSONVILLE	STATE: CA	ZIP CODE:	95076
CAPACITY:	14	CENSUS: 8	DATE:	05/14/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Maria Castillo		TIME COMPLETED:	04:30 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	On 05/14/24 at 12:30 PM., Licensing Program Analyst (LPA) Teodoro Trujillo met with licensee Maria Castillo for an annual 3 year inspection and explained the nature of today’s visit. Present were Licensee and her daughter/assistant Daisy, sister in law/assistant Alejandra Rocha, and assistants Alejandra's 17 year old who is visiting. LPA observed eight children: 6 preschool age, 2 Infants. Adults living in the home are Licensee, her husband Joaquin with two children ages twelve and seven. Days and hours of operation are Monday through Friday, 6:00 am to 6:00 pm. A listing of staff criminal record clearances associated to this facility in the CCL Licensing Information System (LIS) on 04/29/24 was reviewed and it indicates that all Facility staff or other individuals who require caregiver background clearances have received criminal record and child abuse index clearances or exemptions Licensee Maria Castillo was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated. LPA toured the inside and outside of the home. LPA observed a wood burning covered with a waiver on file and no wall heaters. LPA observed no stairs. Off limits indoor: all bedrooms (three), master bathroom, and attached garage. There are no bodies of water. Licensee stated there is a firearm/weapon in the home, firearm and ammunition are stored separately in a locked safe. LPA observed a 3A40BC fire extinguisher that was last serviced on 01/24/24. Smoke detector and Carbon Monoxide detectors are operable. LPA observed sufficient materials, toys, and play equipment for the children in care as well as safe healthful, and comfortable accommodations, furnishings, and equipment. Telephone is in working order. Sharp objects, medicines, poisons and cleaning supplies are inaccessible to the children. Backyard and front yard are fenced. There are two dogs and Licensee stated they are vaccinated. Off limits outdoor: tri level backyard, gated left side yard is used for outdoor play time. *Continues on next page of report dated 05/14/24*

SUPERVISOR'S NAME: Susy Cervantes	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Teodoro Trujillo	TELEPHONE: (408) 334-8547
LICENSING EVALUATOR SIGNATURE:	DATE: 05/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2024

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

FACILITY NAME: CASTILLO, MARIA	FACILITY NUMBER: 444410958
	VISIT DATE: 05/14/2024

NARRATIVE

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Continuation of report dated 05/14/24 pg. 2/3

LPA observed a current roster of the children. LPA observed a fire and disaster drill log last performed on 02/06/24. LPA reviewed 5 children’s files and observed all required documentation was in compliance. Infant individual sleeping plan (LIC 9227) for each infant under 12 months was discussed. LPA observed licensee and her assistants completed Mandated Reporter Training on 02/27/24. Licensee has Pediatric CPR/1^st Aid expiring on 03/03/2025, assistant Daisy, expiring on 2/09/26 and assistant Alejandra, expiring on 02/09/26. Needed documentation for SB 792 which requires immunization against Pertussis, Measles, and Influenza as well as TB testing is current for licensee, assistants, and all adults residing in the home.

Incidental Medical Services (IMS) policy was discussed with the licensee. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The licensee is providing IMS currently. Licensee will submit an updated plan of operation if in the future they provide any IMS services to a child in care.

LPA discussed the safe sleep regulations with licensee Maria Castillo and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee Maria Castillo 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.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.
Continues on next page of report dated 05/14/24 pg. 2/3

SUPERVISOR'S NAME: Susy Cervantes	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Teodoro Trujillo	TELEPHONE: (408) 334-8547
LICENSING EVALUATOR SIGNATURE:	DATE: 05/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2024

LIC809 (FAS) - (06/04)

Page: 4 of 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: CASTILLO, MARIA	FACILITY NUMBER: 444410958
	VISIT DATE: 05/14/2024

NARRATIVE

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Continuation of report dated 05/14/24 pg. 3/3

Licensee Maria Castillo was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the Licensee Maria Castillo, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

No Deficiencies were cited during today's visit.

Exit interview conducted and report was reviewed with the licensee Maria Castillo

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISOR'S NAME: Susy Cervantes	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Teodoro Trujillo	TELEPHONE: (408) 334-8547
LICENSING EVALUATOR SIGNATURE:	DATE: 05/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2024

LIC809 (FAS) - (06/04)

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