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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197400479
Report Date: 01/28/2025
Date Signed: 01/28/2025 05:46:14 PM

Document Has Been Signed on 01/28/2025 05:46 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: 4DATE:
01/28/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
04:16 PM
MET WITH:Lily Castaneda, LicenseeTIME VISIT/
INSPECTION COMPLETED:
05:45 PM
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On 1/28/2025, Licensing Program Analyst (LPA) Isabel Ortega met with Licensee Lily Castaneda to conduct an unannounced case management inspection. Upon arrival, there were 5 children observed in care and 3 staff proving care and supervision.

The purpose of this case management is to follow up on an unusual incident report (UIR) submitted to the Department on 1/24/2025.

The unusual incident report is regarding an injury that occurred during outdoor snack. Child #1 was placed on a picnic table while having a snack and child #1 lost balance and fell back cutting lip on the pavement. During this inspection LPA was provided with the facility roster. LPA toured the outdoor back yard, In addition, LPA completed a safety inspection of the furnishing and equipment.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE: DATE: 01/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/28/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: CASTANEDA FAMILY DAY CARE
FACILITY NUMBER: 197400479
VISIT DATE: 01/28/2025
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According to interviews conducted with staff the children were utilizing the picnic table in the back yard. LPA observed the picnic table furnishing is not age appropriate for child #1. Child #1's legs do not reach the floor. This violates the child's personal rights. One Type B citation issued today.

A notice of site visit was provided and requested to be posted for 30 days.

An exit interview was conducted, a copy of this report, notice of site visit and appeal rights were provided to facility.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE:

DATE: 01/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2025
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Document Has Been Signed on 01/28/2025 05:46 PM - It Cannot Be Edited


Created By: Isabel Ortega On 01/28/2025 at 05:12 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: 01/28/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/14/2025
Section Cited
CCR
102423(a)(2)

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To receive safe, Healthful, and comfortable accommodations, furnishings, and equipment. This requirement was not met by...
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Licensee will utilize smaller tables and chairs with back support for younger children. Licensee will send pictures to the Palmdale Regional Office by due date.
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LPA's observation of the picnic table furnishing. the table does not have back support and not age appropriate for child #1. Child#1's feet do not reach the floor and table. This poses potential health and safety risk to 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: 01/28/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/28/2025


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