197418856-12-12-2022-54-CC-AMOY-CM2TT9-20221212140022

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197418856
Report Date: 12/12/2022
Date Signed: 12/12/2022 02:00:33 PM

Document Has Been Signed on 12/12/2022 02:00 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	CASTELLON FAMILY CHILD CARE		FACILITY NUMBER:	197418856
ADMINISTRATOR:	CASTELLON, CAROLINA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 294-5943
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90062
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 16	CENSUS: 6	DATE:	12/12/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:45 AM
MET WITH:	Carolina Castellon, Licensee		TIME COMPLETED:	02:15 PM

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Licensing Program Analyst (LPA) Alicia Mooberry conducted a Required Annual Inspection on this date. Upon arrival LPA met with Licensee Carolina Castellon, who provided tour of facility. LPA explained the purpose of inspection and provided the inspection Entrance Checklist, LIC 126. LPA inspected rooms/areas on the facility sketch in which child-care services are provided and to which children have access. Per licensee the hours of operation are Monday-Friday 7:00am - 6:30pm. There were six (6) children present, including three (3) infant. Also present was Noemi Martinez, Assistant and Maria Pleitez. Volunteer. All adults present have received the required background clearance. Individuals residing in the home were discussed and noted.

This is a single story home consisting of three bedrooms, two bathrooms, kitchen, living room (main day care area),

Off limit areas include 3 (three) bedrooms, one (1) bathroom (inside master bedroom) and front yard and side areas on both sides of the home and a storage shed in the back yard. LPA observed safety knobs on bedroom doors making bedrooms inaccessible to children in care.

Primary care is provided in the living room located in the front of the home. The kitchen is used during meal time. Children use the bathroom adjacent to the main care area. LPA observed the safety lock in the bathroom that the children uses does not work. Per licensee, the, safety lock will be replace prior to placing cleaning compounds in the cabinet. LPA observed age appropriate toys and learning materials for children. Children nap on mats in the main care area. Infant play yards are available in the living room for infants to nap in.
Per licensee, there is an area by the kitchen and living room that is used as isolation area if children are ill.
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SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2022

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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: CASTELLON FAMILY CHILD CARE	FACILITY NUMBER: 197418856
	VISIT DATE: 12/12/2022

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LPA observed the facility license posted in the living room visible to parent/guardians of children in care. Including Publication (PUB) 394- Notification of Parent Rights and Licensing Form (LIC) 9148- Earthquake Preparedness form. LPA observed completed facility records including; LIC 9040- Facility Roster, LIC 610- Facility Disaster Plan, Fire/Emergency Log Last conducted 6/17/22.

Smoke and carbon monoxide detectors were tested and are operable. Fire extinguisher indicated fully charged and was serviced on Licensee was reminded that fire extinguisher needs to be serviced yearly. The home maintains telephone service via cell phone. The home is observed to be clean and orderly. There are toys and other age appropriate material available for children. LPA observed that cleaning compounds are in kitchen inaccessible to children. The bathroom that children use is located in the observed to be clean and free of hazards.

Licensee states that there are no poisons stored in the home and understands that all poisons must be lock, not only inaccessible to children.

Per Licensee there are no firearms or weapons stored in the home. There are currently no pets.

Isolation area for sick children waiting to be picked up is in living room, away from the other children.

The licensee provides food for children in care.
LPA discussed with licensee the Safe sleep regulations, and provided PIN 20-24-CCP. Licensee states infants sleep in the living room, each infant has their own play yard. Staff supervise infant for the duration of the nap and will document 15 minute checks.
LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee 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.

Currently, children are using the back yard for outdoor play. The outdoor play area was observed to be fenced. LPA observed that the outdoor yard has toys and other materials for children to play.

LPA did not observe any objects that could be hazardous to children in care. Facility does not have a pool or similar bodies of water.
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SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2022

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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: CASTELLON FAMILY CHILD CARE	FACILITY NUMBER: 197418856
	VISIT DATE: 12/12/2022

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Children’s records were reviewed.

Staff records were reviewed for approved Pediatric First Aid and CPR certification, LIC-501: Personnel Record, LIC 508-Criminal Record Statement, LIC 9052- Employee Rights, Proof of immunizations against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, LIC 9108- Statement Acknowledging Requirement to Report Child Abuse and current Mandated Reporter Training Certificate.

LPA discussed current COVID-19 recommendations, precautions and procedures.

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

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.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Based on the LPA's observations and records review no deficiencies will be cited today

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

Exit interview conducted and report was reviewed with the Licensee, Carolina Castellon.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2022

LIC809 (FAS) - (06/04)

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