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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197400479
Report Date: 01/07/2025
Date Signed: 01/07/2025 03:31:10 PM

Document Has Been Signed on 01/07/2025 03:31 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
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: 1DATE:
01/07/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Guadalupe Castaneda, LicenseeTIME VISIT/
INSPECTION COMPLETED:
11:00 AM
NARRATIVE
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LPA Ortega completed a Case management inspection on 1/07/2025. One child was present and two staff providing care and supervision.
Licensee did not report unusual incident occurred on 1/02/2025 within 24 hours to the Palmdale Regional Office. Child #1 sustained a open cut on the lip. Licensee disclosed this incident was not the only time child #1 sustained an injury. According to licensee child#1 was hit on the eye causing a bruise on the eye. According to licensee another child slammed the playhouse door pinching the child #1's eyelid. Title 22 regulation: Section: 10216.2 (b)The licensee shall report to the Department any of the events as specified in Health and Safety Code Sections 1597.467(b)(1)(A) through (b)(1)(C) that occur during the operation of the family childcare home. (C)Any unusual incident or child absence that threatens the physical or emotional health or safety of any child." These incidents shall be reported to the Palmdale office within 24 hours of occurrence and followed by a written report (Unusual Incident Report) within 7 days of incident.

One Type B citation was issued today. Plan of correction was completed. Copy of this report, the Notice of site visit and appeal rights were provided today.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE: DATE: 01/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/07/2025
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 01/07/2025 03:31 PM - It Cannot Be Edited


Created By: Isabel Ortega On 01/07/2025 at 02:27 PM
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: 01/07/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/10/2025
Section Cited
CCR
1024162(b)(c)

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(b) The licensee shall report to the Department any of the events as specified in Health and Safety Code Sections 1597.467(b)(1)(A) through (b)(1)(C) that occur during the operation of the family childcare home. (C) Any unusual incident or child absence that threatens the physical or emotional health or safety of any child." This requirement was not met by...
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Licensee will report all unusual incidents(UIR) to the Palmdale Regional Office within 24 hours by phone and in writing within 7 days. Licensee shall also provide parents with an incident note when an injury has occurred. Licensee will submit the unusual ncident report(UIR) to the Palmdale Regional office by due date by email. Unusualincidentreport@dss.ca.gov
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Licensee disclosed child #1 was injured during care. Child #1 sustained injuries while in care, an Incident report was not reported to the Palmdale Regional Office within 24 hours. This poses a potential health and safety risk to the children in care.
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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:Lady King
LICENSING EVALUATOR NAME:Isabel Ortega
LICENSING EVALUATOR SIGNATURE:
DATE: 01/07/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/07/2025


LIC809 (FAS) - (06/04)
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