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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197419438
Report Date: 07/19/2021
Date Signed: 07/19/2021 12:12:18 PM

Document Has Been Signed on 07/19/2021 12:12 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:CASTILLO FAMILY CHILD CAREFACILITY NUMBER:
197419438
ADMINISTRATOR:CASTILLO, CYNTHIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 488-9263
CITY:GRANADA HILLSSTATE: CAZIP CODE:
91344
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 12DATE:
07/19/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Ashley Jaramillo, AssistantTIME COMPLETED:
12:25 PM
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On 07/19/2021 at 10:00 AM, Licensing Program Analysts (LPAs) Miriam Cohen and Lillian Casillas, conducted an unannounced Annual Required Inspection and was met by Staff #1 (S1). Also present was Staff #2 (S2). During today’s visit, LPA Cohen spoke with licensee, Cynthia Castillo, on the telephone. Per licensee, she is currently at the doctor’s office. Days and hours of operation are Monday through Friday from 7:00 AM – 6:00 PM.
LPAs toured the home inside and outside and a census was taken. Current facility sketch reviewed, and Licensee confirmed that the kitchen, bathroom #1, and the backyard are used for providing care and are accessible to children. All other rooms are off-limits and made inaccessible by use of safety gate and door locks.
There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition on the premises. Firearms and ammunition are stored and locked separately. All poisons are kept in a locked storage area. No poisons were observed during the inspection. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible. The fireplace located in the living room and is made inaccessible by a screen and a lock and will not be in use during day care hours. There are no fireplaces or open face heaters in the home.
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Miriam Cohen
LICENSING EVALUATOR SIGNATURE: DATE: 07/19/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/19/2021
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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: CASTILLO FAMILY CHILD CARE
FACILITY NUMBER: 197419438
VISIT DATE: 07/19/2021
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There is a working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort. There are no stairs in this home. Safe toys and play equipment are observed. The home has working telephone service and LPA confirmed the phone number is (818) 488-9263.

There are currently three infants, older than 12 months, in care during today's inspection. LPA discussed Safe Sleep Regulations with licensee. There is one crib or play yard for each infant in care, cribs and play yards are kept free from all loose articles and objects while infants are sleeping, and there are no objects hanging above or attached to the crib or play yard. Infants are not swaddled while in care. Provider physically checks on sleeping infants every fifteen minutes and documents any signs of distress which includes but is not limited to flushed skin color, increase in body temperature, restlessness and labored breathing. Infants can be visually observed through an open door if sleeping in a separate room. Individual Infant Sleeping Plan is completed and in file for each infant up to 12 months of age. Infants up to 12 months of age are placed on their backs for sleeping.

Licensee ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children. The outdoor play area in the backyard is fenced and there are no hazards to children present. Capacity as specified on the license is being maintained.
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Miriam Cohen
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2021
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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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: CASTILLO FAMILY CHILD CARE
FACILITY NUMBER: 197419438
VISIT DATE: 07/19/2021
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LPA reviewed a sample of children’s files and observed files were complete with emergency information as required. Upon request, copies of the Mandated Reporter Training certification for the licensee, S1, and S2 were not available for LPA to inspect. Licensee’s pediatric CPR/First Aid expires on May 2023. A review of records indicates that all employees and/or volunteers have immunization records on file for influenza, pertussis and measles.
All adults who reside or work in the home have a criminal record clearance or exemption. There are no excluded individuals present at this home.
Incidental Medical Services (IMS) are not currently being provided. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.
LPA and Licensee discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Miriam Cohen
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2021
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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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: CASTILLO FAMILY CHILD CARE
FACILITY NUMBER: 197419438
VISIT DATE: 07/19/2021
NARRATIVE
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Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiencies are being cited:
*Immunization Record H&S 1597.622(a)(1)
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, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.
This requirement is not met as evidenced by observation and records review conducted during today’s inspection. Staff #2 (S2) is missing proof of Pertussis, Measles, and flu/flu waiver vaccines. This poses a potential risk to the health and safety of children in care. LPA discussed the influenza waiver with the S1 during today’s inspection. This is a Type B violation and it poses a potential risk to the health and safety of children in care. Licensee shall ensure all staff and volunteers have appropriate records for immunizations. License to obtain and maintain immunization against influenza, pertussis, and measles for each staff or volunteers present at the facility. During the inspection S2 presented a waiver letter for influenza vaccine.
*Mandated Reporter H&S 1596.862(b)(1)
On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.
This requirement is not met as evidenced by observation and records review conducted during today’s inspection. The licensee failed to ensure that the required mandated reporter assessment was completed and a certification obtained. Licensee, S1, and S2, are missing proof of mandated reporting certification. This is a Type B violation and it poses a potential risk to the health and safety risk of children in care.

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Miriam Cohen
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2021
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Document Has Been Signed on 07/19/2021 04:00 PM - It Cannot Be Edited

Document is an Amendment of Original Document on 07/19/2021 03:52 PM


Created By: Miriam Cohen On 07/19/2021 at 11:44 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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: CASTILLO FAMILY CHILD CARE
FACILITY NUMBER: 197419438

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/19/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/26/2021
Section Cited
HSC
1597.622(a)(1)

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Immunization Record
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, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.
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S1 agrees to send a copy of immunization records for S2 to LPA as proof of evidence by 07/26/2017 by end of business day.
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This requirement is not met as evidenced by observation and records review conducted during today’s inspection. Staff #2 (S2) is missing proof of Pertussis, Measles, and flu/flu waiver vaccines. This poses a potential risk to the health and safety of children in care. LPA discussed the influenza waiver with the S1 during today’s inspection. This is a Type B violation and it poses a potential risk to the health and safety of children in care. Licensee shall ensure all staff and volunteers have appropriate records for immunizations. License to obtain and maintain immunizations against influenza, pertussis, and measles for each staff or volunteers present at the facility. During the inspection S2 presented a waiver letter for influenza vaccine.
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Type B
07/26/2021
Section Cited
HSC1596.862(b)(1)

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Mandated Reporter
On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years
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S1 agrees to send a copy of Mandated Reporting Certification for Licensee, S1, & S2 to LPA as proof of evidence by 07/26/2017 by end of business day.
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following the date on which he or she completed the initial mandated reporter training.
This requirement is not met as evidenced by observation and records review conducted during today’s inspection. The licensee failed to ensure that the required mandated reporter assessment was completed and a certification obtained. Licensee, S1, and S2, are missing proof of mandated reporting certification. This is a Type B violation and it poses a potential risk to the health and safety risk of 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:Maureen Neal
LICENSING EVALUATOR NAME:Miriam Cohen
LICENSING EVALUATOR SIGNATURE:
DATE: 07/19/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/19/2021


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