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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197400479
Report Date: 05/08/2024
Date Signed: 05/08/2024 11:39:28 AM

Document Has Been Signed on 05/08/2024 11:39 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:CASTANEDA FAMILY DAY CAREFACILITY NUMBER:
197400479
ADMINISTRATOR/
DIRECTOR:		GUADALUPE CASTANEDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 765-5345
CITY:SUN VALLEYSTATE: CAZIP CODE:
91352
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
05/08/2024
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:Guadalupe Castaneda TIME VISIT/
INSPECTION COMPLETED:
11:45 AM
NARRATIVE
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To complete the evaluation conducted on 5/1/24, Licensing Program Analyst (LPA) Evelyn Garcia returned to the facility on this date, 5/8/24 to review staff files and facility forms required. Upon arrival LPA met with licensee Guadalupe Castaneda and waited for staff#1 to arrive from running an errand. Staff #1 returned at 9:45am. At the time of inspection there were 3 preschool children, and 1 infant present. All adults present in the home were finger printed and cleared.

One Type B deficiency is being issued today for Section 1597.622a1: See LIC809-D

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.

An exit interview was conducted with Guadalupe Castaneda and Staff #1.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Evelyn Garcia
LICENSING EVALUATOR SIGNATURE: DATE: 05/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/07/2024
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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Document Has Been Signed on 05/08/2024 11:39 AM - It Cannot Be Edited


Created By: Evelyn Garcia On 05/08/2024 at 10:57 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: CASTANEDA FAMILY DAY CARE
FACILITY NUMBER: 197400479

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/08/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/08/2024
Section Cited
HSC
1597.622a1

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Employees or volunteers at family day care home; immunization requirements; records; exemptions: Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, tb test, pertussis, and measles.
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The licensee agrees to provide proof that she and her assistant have been immunized against pertussis, measles and influenza, and TB test or must get immunized against the above vaccinations and provide proof to CCLD by plan of correction date 5/9/24.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Mariela Ramon
LICENSING EVALUATOR NAME:Evelyn Garcia
LICENSING EVALUATOR SIGNATURE:
DATE: 05/08/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/08/2024


LIC809 (FAS) - (06/04)
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