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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483009971
Report Date: 10/06/2021
Date Signed: 10/06/2021 11:51:36 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA
FACILITY NAME:CASTON, MAXINE FCCHFACILITY NUMBER:
483009971
ADMINISTRATOR:CASTON, MAXINEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 557-4375
CITY:VALLEJOSTATE: CAZIP CODE:
94589
CAPACITY:14CENSUS: 3DATE:
10/06/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:40 AM
MET WITH:Maxine Caston, LicenseeTIME COMPLETED:
12:05 PM
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A Required- 1 year inspection was made to the facility by Licensing Program Analyst (LPA) Kevin O'Connell. A review of staff records on 10/06/21 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Currently there are two adults living in the home.
During today’s inspection the home and grounds were toured.
The licensee and an assistant were supervising three children, and operating within the licensed capacity and ratio requirements. No children were observed left in any parked vehicle. The facility’s operating hours are Monday - Friday; 05:00am - 11:45pm.
The two playrooms (bedrooms) and bathroom on the left near the entrance are accessible to the children.
The "off limits" areas (Main bedroom, living room, family room, dining room, kitchen, dog room have been made inaccessible by means of child gates.
The back yard & front yards are fully fenced and used for outdoor play. The home was clean and was at a comfortable indoor temperature. There were safe toys and equipment available for children. There is a working telephone in the home. The Licensee has current pediatric CPR and First Aid certifications which expires 01/22. Items which could pose a danger to children (detergents, cleaning compounds, medications, etc.) were stored out of the reach of children. Poisons are key locked in the combination locked attached garage. (only one door)
The fireplace insert has a glass door, is not used and is barricaded with large plants and is located in an "off limits" area..
There is a working smoke detector & carbon monoxide detector and at least one 2A 10BC charged fire extinguisher. Licensee states that there are no firearms or dangerous weapons and none were observed. The Licensee states that there are no pools, spas, or water features and none were observed.
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Kevin O'ConnellTELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:

DATE: 10/06/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2021
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,
, CA
FACILITY NAME: CASTON, MAXINE FCCH
FACILITY NUMBER: 483009971
VISIT DATE: 10/06/2021
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Two staff files were reviewed at 10:55am for Mandated Reporter Certificates and immunizations. Three children's records were reviewed at 11:15am; required emergency information cards were observed to be on file. No children need or are receiving Incidental Medical Services at this time.
The following information regarding ADA was provided: US Department of Justice 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, www.ada.gov/childqanda.htm. This report was reviewed and discussed with the licensee.
All licensing reports are public information and must be made available upon request for at least three years.

Notice of Site Visit shall be posted for 30 days from today's visit.

No Title 22 violations were cited during today's inspection.
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Kevin O'ConnellTELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:

DATE: 10/06/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2021
LIC809 (FAS) - (06/04)
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