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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198400040
Report Date: 08/22/2024
Date Signed: 08/22/2024 12:14:37 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/16/2024 and conducted by Evaluator Anthony Padilla
COMPLAINT CONTROL NUMBER: 54-CC-20240816135226
FACILITY NAME:CASTELLANOS & LOPEZ MENDEZ FAMILY CHILD CAREFACILITY NUMBER:
198400040
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: DATE:
08/22/2024
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:TIME COMPLETED:
12:38 PM
ALLEGATION(S):
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Uncleared adult resides in the home
INVESTIGATION FINDINGS:
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Inspection was conducted in English and Spanish with translation support from Licensee adult daughter Elizabeth Castellanos.
Licensing Program Analyst (LPA) Anthony Padilla conducted an unannounced visit at Castellanos & Lopez Mendez Family Child Care for the purpose of investagating the above complaint allegation. Upon arrival LPA met with Co-Licensee Kenia Castellanos who greeted LPA and granted access to facility. LPA observed 1 child i the main care room and 1 child sleeping for a total of 2 children present. At 10:00 AM child 3 (C3) was dropped off for care. Licensee provided a tour of the inside and outside parts of the facility including on limits and off limits areas of the facility. LPA did not observe anything hazardous or dangerous that could pose a risk to children in care. All children present were treated with dignity and respect. During the course of the inspection LPA was able to collect LIC 9040 current childrens roster, interviwed personnel interviews. Interview conducted disclosed that Eduardo Gomez does visit licensee during hours of operation and resides at the facility on Fridays through the weekends. Licensee confirmed that Eduardo Gomez arrvies usually Friday evening around 7:00 PM. Hours of operation are Monday-Friday 6:00AM-9:30 PM
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Anthony Padilla
LICENSING EVALUATOR SIGNATURE:

DATE: 08/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 54-CC-20240816135226
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: CASTELLANOS & LOPEZ MENDEZ FAMILY CHILD CARE
FACILITY NUMBER: 198400040
VISIT DATE: 08/22/2024
NARRATIVE
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LPA informed licensee that all adults 18 or over who have access to facility during hours of operation shall obtain a criminal clearance and association to facility before being able to access facility
Based on the available information provided during interviews, the preponderance of evidence standard has been met, therefore the above allegation occurred at the facility and is substantiated.
Based on information from interviews conducted the following deficiency on LIC 9099D are being cited today 8/22/24. LPA Anthony Padilla informed licensee Kenia Castellanos 1 Type A citation. Type A citation shall be posted for 30 consecutive days as there is a immediate risk to health and safety or personal rights of children in care. LPA Anthony Padilla informed Licensee to provided a copy of this licensing report dated 8/22/24 that documents Type A citation to parents/guardians of all children currently enrolled by the next business day or next day when children are in care and to any new children enrolled for the following 12 months from the date of this report. A signed acknowledgment of receipt of licensing report (LIC 9224) or other written statements must be placed in children's file for verification.
A violation regarding (102370(d)(1) criminal record clearance) warrants an immediate civil penalty of $200 and is hereby assessed. See LIC 421IM.
An exit interview was conducted with Licensee Kenia Castellanos and a notice of site visit was provided along with appeal rights.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Anthony Padilla
LICENSING EVALUATOR SIGNATURE:

DATE: 08/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 54-CC-20240816135226
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: CASTELLANOS & LOPEZ MENDEZ FAMILY CHILD CARE
FACILITY NUMBER: 198400040
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/22/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/23/2024
Section Cited
CCR
102370(d)(1)
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All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing, or volunteering in a licensed facility:
(1) Obtain a California clearance or a criminal record exemption...This regulation was not met as evidence by;
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Licensee states she will not allow Eduardo Gomez to access facility until finger prints clearance is granted.
Licensee states she wil have Eduardo Gomez obtain finger prints and clearance.
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Basee on LPA's interview licensee confirmed that uncleared adult resides in the home. This poses an immediate health saftey and personal rights 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.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Anthony Padilla
LICENSING EVALUATOR SIGNATURE:

DATE: 08/22/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3