<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400040
Report Date: 04/29/2024
Date Signed: 04/30/2024 01:41:51 PM

Document Has Been Signed on 04/30/2024 01:41 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:CASTELLANOS & LOPEZ MENDEZ FAMILY CHILD CAREFACILITY NUMBER:
198400040
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 2DATE:
04/29/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:25 PM
MET WITH:Licensee Kenia Castellanos TIME VISIT/
INSPECTION COMPLETED:
06:35 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analysts (LPAs) Ashley Calderon and Alicia Mooberry conducted an unannounced Annual Inspection in Spanish on this date. Upon arrival LPAs met with Licensee Kenia Castellanos who allowed LPAs entry. LPAs explained the purpose of the inspection and a tour of facility was conducted alongside with Licensee Kenia. LPAs inspected rooms/areas on the facility sketch in which child-care services are provided and to which children have access too. LPAs provided the inspection Entrance Checklist, LIC 126. Per licensee the hours of operation are Monday-Saturday 7am - 7:00pm.

LPA discussed Overnight care regulations and reminded licensee care provided during the day and overnight combined shall not exceed 24 hours from the time the child entered into care.

This is a single story home with 2 bedrooms, living room, kitchen and 1 bath. All areas of the home are accessible to children care. The main daycare are is located in the living room, the bedroom #1 is used for sleeping. At 2:35pm LPAs observed two child in care sleeping on individual toddler mattresses, child #1/ age 16 months was sleeping on 2 mattress stocked up on top of each other, rising the bed off the floor at 1 foot 1/2. Licensee and Staff /Assistant was advised this can pose as a health and safety risk for the children in care.

Off limit areas are: Font yard and detached one (1) car garage, laundry room inaccessible and located in the backyard yard. Areas that are used by children were inspected for safety, comfort, cleanliness, telephone service, ventilation and heating. The licensee provides food for children in care.

The following was observed and reviewed during this inspection:



(Page 1 – Report Continues)
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Ashley Calderon
LICENSING EVALUATOR SIGNATURE: DATE: 04/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/29/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: 04/29/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
LPAs observed the facility license, Publication (PUB) 394- Notification of Parent Rights, LIC 9148 Earthquake Preparedness and Emergency Disaster Plan. LPAs reviewed staff files, Mandated Reporter Training Expired 6/3/23 for Licensee Kenya and LPA's advised to have staff files in place, licensee was unable to provide employee files during time of visit. CPR for Licensee Kenya Expires on 8/26/25.All individuals at the home were cleared, LPA's during visit provided LIC9182 Criminal Record Clearance Transfer form for Elizabeth Castellanos. Individuals residing in the home were discussed and noted. Emergency Drill was conducted on 4/4/24. During visit two children Child #1 and Child #2 were present and no children file was provided to LPA's. Smoke detectors were tested and was operable. Carbon monoxide was tested and device was not clear on reading for precaution LPA's advised to replace device with a new device. Fire extinguisher indicated fully charged and was purchased on 04/16/23, Licensee was reminded that fire extinguisher needs to be serviced yearly. The home maintains telephone service via cell phone. There are toys and other age appropriate material available for children. The bathroom that children use is located in the hallway observed to be clean and LPA's found chemicals under sink accessible to children in care, Licensee placed chemicals out of reach of children during visit and LPA's advised that chemicals, detergents and poisons need to be inaccessible to children for the safety of the children. Per Licensee there are no firearms or weapons stored in the home. Licensee stated the Isolation area for sick children waiting to be picked up is licensee's bedroom #2, away from the other children. Kitchen was inspected and LPA's noticed alcohol displayed on shelves on the kitchen wall, near sink. LPA's advised alcohol should be inaccessible to children in care as it can pose a risk to the children in care, Licensee removed bottom shelf that stored alcohol. LPAs observed that cleaning compounds are in locked kitchen inaccessible to children.
Infant Care: LPA informed licensee of the new Safe sleep regulations, discussed PIN 20-24-CCP, LIC 9227 Infant Sleep Plan for infants under 12 months, 15-minute sleep check documentation for infants 0-24 months. Licensee during time of visit was unable to provide sleep log for Child #1. Licensee states there is a crib in storage available for infants if/when needed. 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. (Page 2 – Report Continues)
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Ashley Calderon
LICENSING EVALUATOR SIGNATURE:

DATE: 04/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2024
LIC809 (FAS) - (06/04)
Page: 3 of 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: 04/29/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Currently, children are using the back yard for outdoor play. The outdoor play area was observed to be fenced, there are two play areas. The back end of the play yard was blocked off due to construction occurring after day care hours, licensee stated they are adding a garden and an extra shade to the backyard. LPA's advised to report any construction that restricts and changes day care daily actives. LPAs observed that the outdoor yard has toys and other materials for children to play with including a large trampoline with safety netting that zips and locks, swings which is anchored to the ground with grass that cushions under structure. LPAs discussed trampoline to be used according to the manufacturer recommendations and trampoline safety resource were provided. Per licensee, the children are supervised when playing outside. LPAs observed preschool ages plastic structure with slides. LPAs did not observe any objects that could be hazardous to children in care. LPA observed 4 locked storage shed at the rear of the back yard containing children toys, storage and tools. Facility does not have a pool or similar bodies of water, small water foutain feature was observed on top of a table inaccessible to young children in care, LPA's advised Licensee to take water safety measures as summer time is approaching. Per licensee, there are no pets in the home.

Licensee stated no children in care are on medication. 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, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.



(Page 3-- Report continues)
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Ashley Calderon
LICENSING EVALUATOR SIGNATURE:

DATE: 04/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2024
LIC809 (FAS) - (06/04)
Page: 2 of 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: 04/29/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
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 the following deficiencies will be cited today in accordance with California Title 22 Regulations, See LIC 809-D's.

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

Exit interview conducted and report was reviewed with the Licensee, Kenia Castellanos



(Page 4-End of report)
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Ashley Calderon
LICENSING EVALUATOR SIGNATURE:

DATE: 04/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2024
LIC809 (FAS) - (06/04)
Page: 4 of 7
Document Has Been Signed on 04/30/2024 01:41 PM - It Cannot Be Edited


Created By: Ashley Calderon On 04/29/2024 at 05:26 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
, 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: 04/29/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(4)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observations, the licensee did not comply with the section cited above in 1 out of 1 bathroom, was observed to have a cabinet under sink not lock and chemicals were found stored in cabinet, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/06/2024
Plan of Correction
1
2
3
4
Per Licensee, during time of visit removed chemicals and placed in cabinet in kitchen that is inaccessible to children in care and Licensee informed LPA Calderon that she will place a lock on cabinet in the bathroom. Licensee will send a picture to LPA Calderon.
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day 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:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above in [3] out of [3] staff had missing training or need to renew training, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/06/2024
Plan of Correction
1
2
3
4
Licensee will conduct training as well as co licensee and assistant staff, will provide copies of certification to LPA Calderon via email by POC due date.
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:Valarie Cook
LICENSING EVALUATOR NAME:Ashley Calderon
LICENSING EVALUATOR SIGNATURE:
DATE: 04/29/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/29/2024


LIC809 (FAS) - (06/04)
Page: 5 of 7
Document Has Been Signed on 04/30/2024 01:41 PM - It Cannot Be Edited


Created By: Ashley Calderon On 04/29/2024 at 05:26 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
, 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: 04/29/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416.1(d)
Personnel Records
(d) All personnel records shall be maintained at the child care home and shall be available to the licensing agency for review.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above in [3] out of [3] staff did not have staff records avaiable for review which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/06/2024
Plan of Correction
1
2
3
4
LPA Calderon provided list of personnel records to complete and send copies to LPA by POC due date for total of 3 persons.
Section Cited
Immunizations
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
4
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:Valarie Cook
LICENSING EVALUATOR NAME:Ashley Calderon
LICENSING EVALUATOR SIGNATURE:
DATE: 04/29/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/29/2024


LIC809 (FAS) - (06/04)
Page: 6 of 7
Document Has Been Signed on 04/30/2024 01:41 PM - It Cannot Be Edited


Created By: Ashley Calderon On 04/29/2024 at 05:26 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
, 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: 04/29/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102421(a)
Child's Records
(a) The licensee shall maintain, in each child's record, the signed and dated notice form required in Section 102419(d).

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above in 2 out of 2 children in care did not have records avaialable for review which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/06/2024
Plan of Correction
1
2
3
4
LPA Calderon provided list of required childrens records, Licensee will provide via email records by POC due date.
Type B
Section Cited
CCR
102425(j)(2)(D)
Infant Safe Sleep
Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above in [2] out of [2] children did not have Infant Sleep Log completed, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/06/2024
Plan of Correction
1
2
3
4
Licensee was provided a Sleep Log and advisory on Infant Sleep and Licensee will provide a completed sleep log for Child #1 and #2 by POC due date.
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:Valarie Cook
LICENSING EVALUATOR NAME:Ashley Calderon
LICENSING EVALUATOR SIGNATURE:
DATE: 04/29/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/29/2024


LIC809 (FAS) - (06/04)
Page: 7 of 7