073409371-4-13-2023-02-CC-CCON-CQUQAR-20230413120021

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073409371
Report Date: 04/13/2023
Date Signed: 04/13/2023 12:00:31 PM

Document Has Been Signed on 04/13/2023 12:00 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
BAY AREA-CC OAKLAND, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME:	ESTRADA CASTILLO, JOSE		FACILITY NUMBER:	073409371
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 0	DATE:	04/13/2023
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Jose Estrada Castillo		TIME COMPLETED:	12:15 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 Thursday, April 13, 2023 at 9:30 AM, Licensing Program Analyst (LPA) Caroline Colson met with Jose Estrada Castillo and Elsy Mejia, Spanish Interpreter and friend, for an announced prelicensing and technical assistance inspection. There are no day care children present. The home was toured to conduct a health and safety inspection. All required forms were reviewed and provided to the applicant. Operating Hours are Mondays - Fridays 7:00 AM - 5:00 PM Indoor Space: The home is a two story home. The home consist of a living room, dinning area, kitchen, two downstairs bedrooms, one downstairs bathroom, one upstairs studio which includes a bedroom, kitchenette, closet, patio and bathroom, one downstairs hallway closet, downstairs laundry/storage room, fenced front yard and fenced back yard. There is a working combination smoke detector and carbon monoxide detector. Mr. Estrada Castillo states that there are no firearms in the home. There are toys and play equipment available for the children. His CPR and First Aid certificates are current and expire on December 3, 2024. He has current Mandated Reporter Training certificates which expire on October 6, 2024 and December 9, 2024 respectively. There is a First Aid Kit available. The isolation area will be the dinning area. Outdoor Play Space: The children will play in the fenced front yard. Off Limit Areas: All bedrooms, downstairs hallway closet, upstairs studio, laundry/storage room and fenced back yard are the inaccessible areas. Please See LIC 809 C for Additional Information

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Caroline Colson
LICENSING EVALUATOR SIGNATURE:	DATE: 04/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2023

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 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
BAY AREA-CC OAKLAND, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: ESTRADA CASTILLO, JOSE	FACILITY NUMBER: 073409371
	VISIT DATE: 04/13/2023

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
26
27
28
29
30
31
32

The following items need to be corrected by May 13, 2023:
1. Applicant needs to purchase fitted sheets for the playpens.
2. Applicant needs to make the laundry/storage room inaccessible to children.
3. Applicant needs to remove the gate from the kitchen.
4. Applicant needs to submit his last Pertussis vaccine when it is due.
5. Applicant needs to place a lock on the door that leads to the first bedroom.

REMINDERS/RESOURCES

· CCLD Complaint Hotline, 1-844-LET-US-NO (1-844-538-8766) email: LetUsNo@dss.ca.gov

CCLD website address for obtaining licensing forms, training videos and other provider resources can be obtained at www.ccld.ca.gov

· Licensees may register to receive child care updates: www.myccl.ca.gov

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 ADA, available at: http://www.ada.gov/childquanda.htm

Please See LIC 809 C for Additional Information

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Caroline Colson
LICENSING EVALUATOR SIGNATURE:	DATE: 04/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2023

LIC809 (FAS) - (06/04)

Page: 2 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
BAY AREA-CC OAKLAND, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: ESTRADA CASTILLO, JOSE	FACILITY NUMBER: 073409371
	VISIT DATE: 04/13/2023

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
26
27
28
29
30
31
32

Family Child Care Homes

Licensee 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.

Safe Sleep

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee, Jose Estrada 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.

Notice of Site Visit

A notice of site visit was given and must remain posted for 30 days.

Exit Interview

Exit interview conducted and report was reviewed with the applicant, Jose Estrada Castillo.

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Caroline Colson
LICENSING EVALUATOR SIGNATURE:	DATE: 04/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2023

LIC809 (FAS) - (06/04)

Page: 3 of 3