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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198004806
Report Date: 02/21/2023
Date Signed: 02/21/2023 11:54:37 AM

Document Has Been Signed on 02/21/2023 11:54 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:CASTELLON FAMILY CHILD CAREFACILITY NUMBER:
198004806
ADMINISTRATOR:CASTELLON, ANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 868-4178
CITY:NORWALKSTATE: CAZIP CODE:
90650
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 7DATE:
02/21/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Licensee Ana CastellonTIME COMPLETED:
12:00 PM
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On 2/21/2023 Licensing Program Analyst (LPA) Jeanette Estrada conducted an unannounced required 1 year inspection at the above facility. LPA met with the Licensee Ana Castellon and informed her of the purpose for the visit. LPA provided Licensee with a copy of the Facility Entrance Checklist. There were six children and one additional staff present at the time of arrival. One additional child arrived at approximately 9:54AM. Facility is in compliance for a large family child care home.
All residents were noted and verified. All criminal record clearances for adults present were verified. Facility provides care to children ages 0 to 13 years old and the facility operates Monday through Friday 6AM to 6 PM.
This is a two bedroom, two bathroom home with two additional day care rooms towards the back of the home.
Per Licensee areas on limits to children are: The enclosed yard, two day care rooms and the bathroom in the day care room.
Per Licensee areas off limits to children are: Front part of the home which includes the living room, kitchen, two bedrooms, one bathroom, the garage and a section of the backyard that is separated by a gate.
All areas that are accessible to children were inspected for safety, comfort, and cleanliness. The following was observed and reviewed during this inspection: LPA observed required posted documentation- Facility license, Publication (PUB) 394- Notification of Parent Rights and Licensing Form (LIC) 9148- Earthquake Preparedness form, LIC 9040 Facility Roster and a disaster drill log. Licensee had a current copy of the facility roster and the last documented disaster drill was conducted on 2/6/23. There is an operable smoke detector in one of the day care rooms and operable carbon monoxide detector in the kitchen. LPA observed two 2A10BC Fire Extinguishers in the facility which indicated full and were last serviced on 8/2022. The home maintains telephone service. Food is provided by Licensee. Licensee was reminded if children bring food from home it must be labeled with the child’s name and properly stored or refrigerated.
There are toys and other age appropriate materials available for children to use in the day care rooms. Sharp objects, detergents and cleaning compounds were in the kitchen inaccessible to children in care. Children do not have access to the kitchen. The entrance door from the kitchen to the day care room is maintained closed during operating hours.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE: DATE: 02/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/21/2023
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: 198004806
VISIT DATE: 02/21/2023
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Personal medication is kept in the off limits section of the home and per Licensee, no children enrolled require medication.
There is a wall A/C unit in one of the day care rooms and per the Licensee, a portable heater is used when needed. The bathroom in the day care room was inspected for safety. LPA observed the cabinet latch under the sink had been dislodged. LPA observed cleaning products in the cabinet. LPA observed the door to the bathroom was closed when LPA entered the day care room. LPA observed a stepping stool was blocking access to the cabinet. LPA observed Licensee secure the latch on the cabinet and advised to ensure the latch is properly attached. Per Licensee, children present are potty training and are supervised when using the restroom. Children use a section of the enclosed backyard for outdoor play. LPA observed age appropriate toys and materials for children.
Per Licensee there are no poisons in the home. Licensee was advised that all poisons must be locked, not only inaccessible to children. Isolation area for sick children waiting to be picked up is in enclosed patio supervised by an adult. Per Licensee, there are no firearms or weapons stored in the home. There are no pools or spas, or other bodies of water. There is a pet dog in the home. Per Licensee, pet dog is maintained in the off limits section of the home.
Infant Care: Currently licensee cares for three infants. LPA observed one crib and one play yard in the playroom. Per Licensee, one of the infants has transitioned to a napping mat. Napping equipment does not block entrances or exits. Infant mattresses were observed to be firm with tightly fitted sheets. LPA did not observe loose object, bumpers, objects hanging, or objects attached to the cribs. There is currently one infant who uses a pacifier. LPA observed pacifier does not have anything attached to it. Per licensee wet or soiled sheets are laundered in the facility. Each infant has their own crib/ napping mat and bedding. LPA observed sleeping logs for three infants enrolled.
Overnight Care: There is no overnight care provided at the moment. LPA discussed the following in case overnight care is provided: Licensee is aware that they must remain wake while children are awake. If children sleep in separate area from licensee, the door must remain open. If licensee cannot hear children when they wake up, video or audio device can be used.
Children’s records were reviewed and included (LIC) 282- Affidavit Regarding Liability Insurance, Immunizations Records, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights, LIC 9227- Individual infant sleep plan form (0-12 months, and documentation of 15-minute Infant Sleep Check (0-24 months)
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 02/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2023
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: 198004806
VISIT DATE: 02/21/2023
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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 of Child and Mandated Reporter Training Certificate.
Licensee and Assistant have Pediatric First Aid/CPR certification issued by the American Red Cross that was completed on 8/20/2022. Licensee and Assistant have both completed the Mandated Reporter for child care providers training on 8/19/2022. Both staff have proof of required immunization against pertussis, measles and flu (flu declination) and proof of TB clearance.
During inspection all children were observed to be treated with dignity and respect, they were observed to be receiving safe, healthful and comfortable accommodations, furnishings and equipment, and free from corporal and/or unusual punishment.
Incidental Medical Services (IMS):
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 Center 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.
LPA discussed the safe sleep regulations with Licensee and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleephttps://www.cdss.ca.gov/inforesources/child-care-licensing/ public -information-and-resources/safe-sleep as an additional resource.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 02/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2023
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: 198004806
VISIT DATE: 02/21/2023
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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.
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/process.
Exit interview conducted and report was reviewed with the Licensee, Ana Castellon. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 02/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2023
LIC809 (FAS) - (06/04)
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