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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444416037
Report Date: 02/17/2022
Date Signed: 02/28/2022 04:40:50 PM


Document Has Been Signed on 02/28/2022 04:40 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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131



FACILITY NAME:CASTILLO, ANGELICAFACILITY NUMBER:
444416037
ADMINISTRATOR:ANGELICA CASTILLOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 707-9313
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY:14CENSUS: DATE:
02/17/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
02:10 PM
MET WITH:Angelica CastilloTIME COMPLETED:
03:45 PM
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On 02/17/2022 at 2:10 AM, Licensing Program Analyst (LPA) Elizabeth Berumen conducted an announced pre-licensing visit to the home. LPA met with Applicant, Angelica Castillo and explained the nature of today's inspection to her. Angelica, her husband (Alejandro Castillo) and her mother (Jovita Rocha). Angelica was previously licensed at 10410 Geil Street Castroville, CA 95012. Applicant's license 274415433 was closed due to her moving.

Days and hours of operation will be Monday - Friday from 6:00 AM to 5:00 PM.
Applicant has completed her Preventative Health and Safety Child Care Training including the nutrition and lead poisoning; a copy of completion is on file. Applicant's CPR and First Aid certifications are current and expire on 10/28/2023. Mandated Reporter Training was completed on 03/19/22. Applicant owns the home; copy of mortgage statement was obtained during today's inspection. Applicant does not have liability insurance and will issue affidavit regarding liability insurance for FCCH.

LPA toured the entire indoor and outdoor areas during today's inspection.
Off limit areas in the home are bedroom 1 (located downstairs) entire upstairs (bedroom 2,3,4) and garage. Licensee's backyard is fenced all around and safe for children. Licensee has a pet dog that is kept in side yard. LPA observed a barricaded fire place in living room #2. LPA observed that the stairs are barricaded.

Applicant, Angelica Castillo was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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.
SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Elizabeth BerumenTELEPHONE: (408) 318-1326
LICENSING EVALUATOR SIGNATURE:
DATE: 02/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/17/2022
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: CASTILLO, ANGELICA
FACILITY NUMBER: 444416037
VISIT DATE: 02/17/2022
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LPA observed a fully charged 2A10BC fire extinguisher, working smoke and carbon monoxide detector. Applicant states that there are no weapons in the home. Cleaning products, toxic agents, and sharp objects are inaccessible to children and stored in high kitchen pantry. Medication is stored off limits to children in high kitchen cabinet.

LPA reminded Applicant that smoking, baby walkers, bouncers, jumpers, and similar items are not allowed in Family Child Care Homes. Forms of discipline used by Applicant: redirection and talking. Applicant understands that children's personal rights should not be violated; including no corporal punishment.

LPA discussed the safe sleep regulations with applicant and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed [applicant, 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.

LPA reviewed with applicant the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted.

Licensee agrees to submit a revised Emergency disaster plan (LIC610) Licensee listed a licensed day care facility as an emergency re-location site.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Exit interview conducted and report was reviewed with the Applicant, Angelica Castillo. Fire clearance approved on 01/27/2022.

A large license capacity 14 is approved today.

SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Elizabeth BerumenTELEPHONE: (408) 318-1326
LICENSING EVALUATOR SIGNATURE:

DATE: 02/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/17/2022
LIC809 (FAS) - (06/04)
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