198400444-8-6-2021-54-CC-AJLO-C5MTZS-20210806151048

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198400444
Report Date: 08/06/2021
Date Signed: 08/06/2021 03:11:00 PM

Document Has Been Signed on 08/06/2021 03:11 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:	CASTRO & EYMAN FAMILY CHILD CARE HOME		FACILITY NUMBER:	198400444
ADMINISTRATOR:	KELSIE CASTRO,ERIC EYMAN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(562) 232-3491
CITY:	LAKEWOOD	STATE: CA	ZIP CODE:	90712
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	08/06/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Kelsie Castro & Eric Eyman, Applicants		TIME COMPLETED:	03:30 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 Analyst (LPA) A. Lucero conducted a Pre-License inspection to the above facility. LPA met with applicants Kelsie Castro and Eric Eyman who guided analyst on tour of the facility. People residing in the home have been discussed and noted. All areas identified on the facility sketch were inspected, including but not limited to, off limit areas. This is a one story home that consists of three bedrooms, two bathrooms, dining area, living room, kitchen, attached garage, front and back yards. Applicants states that care will be provided at the address the department has on file and applicants state that they live in the home where care will be provided. LPA observed a fireplace in the living room without proper deterrent from gaining access. Per applicants, the children will use the living room, dining area, one bathroom located in hallway, office, and back yard. Areas that will be used by children were inspected for safety, comfort, cleanliness, telephone service (cell phone), ventilation and heating. Detergents, cleaning compounds, medicines, sharp objects and hazardous items that can pose a danger to children are inaccessible in areas designated for children. The applicant was advised that any poisons must be locked with a key or combination lock at all times. Based on the Facility Sketch submitted, areas off limits to children and parents are: kitchen (except in passing to back yard), two bedrooms, front yard, and attached garage. The applicant understands that licensing staff may have access to off-limit areas during inspection visit if necessary. The children will use the back yard, which was observed to be fenced. LPA advised the Applicant that children will need to be physically and visually supervised at all times. Per applicant, there are no firearms, weapons or bodies of water on the premises. No bodies of water were observed.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Armando J Lucero
LICENSING EVALUATOR SIGNATURE:	DATE: 08/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2021

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: CASTRO & EYMAN FAMILY CHILD CARE HOME	FACILITY NUMBER: 198400444
	VISIT DATE: 08/06/2021

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The valve on the 2A10BC fire extinguisher indicates fully charged. Smoke and carbon monoxide detectors were tested and are operable. The applicant states that they will provide snacks for children in care and parents are expected to provide lunch. If food is not provided and food is brought from the children’s homes; containers shall be labeled with child’s name and properly stored or refrigerated.

LPA discussed protocol in place in regards COVID-19. Applicant stated protocol in place is having parents not fully enter the facility and sign in and out will take place at the front door entrance. The child care area is big enough to meet the 6 feet distance. Applicant will scan the children for any symptoms such as fever, running nose, cough or child's behavior and will inform parent child cannot stay if any symptoms related to COVID-19 or if symptoms appear during the day, applicant will isolate the child and call parent for pick up. Children will wash their hands during arrival, entering the facility from outdoor play, meal times, covering their cough and using the restroom. LPA observed hand washing posters posted in the bathroom and COVID-19 symptoms poster in the front entrance and hand sanitizer for parents (inaccessible to children). Applicant stated they are aware of cleaning, disinfecting and sanitizing and the importance of the constant hand washing. Technical Assistance was conducted with applicant on the date of this tele-inspection; LPA reviewed the Technical Assistance with applicant on this date.

The following was discussed with the applicant:

· Individuals who are 18 years of age or older living in the home must obtain a criminal record clearance. Individuals within one month of their 18th birthday must be fingerprinted immediately. Civil Penalties will be assessed if not in compliance.
· In the absence of the licensee a qualified adult must be present supervising the children; a qualified adult is an individual who has a valid and current Pediatric First Aid and CPR training, Immunization (TDAP, MMR, Influenza), mandated reporter training and a valid criminal record clearance associated to the facility license
· Annual fees must be paid promptly and by the due date or a late fee shall be assessed and/or the License may be terminated.
·The fire extinguisher type 2A-10BC must be serviced annually or as often as necessary. Smoke and carbon monoxide detectors should be checked and batteries replaced as needed.
· Reporting Requirements: Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your home.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Armando J Lucero
LICENSING EVALUATOR SIGNATURE:	DATE: 08/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2021

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: CASTRO & EYMAN FAMILY CHILD CARE HOME	FACILITY NUMBER: 198400444
	VISIT DATE: 08/06/2021

NARRATIVE

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· Reporting Requirements: Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing.
· Fire and safety drills must be performed every six months and documented for review by the Department.
· Smoking is prohibited in a family child care home.
· Children and Staff records must be maintained and updated as needed and must be available for review by the Department.
· No infant walkers, No Johnny jumpers, No saucer chairs, No trampolines and any other item that falls into that category are not permitted in the facility.
· Inspection Authority: All adults living and working in the home shall be made of aware of the Department’s right to inspection the home, which includes, but is not limited to the right to enter the home when children are being cared for, interview children and adults and review documentation.
· The facility license number must be on all advertisements, publications or announcements with the intent to attract clients.
· Isolation for Ill children: When a child is ill he/she shall be separated from other children (reference 102417(e) Operation of a Family Child Care Home).
· Immunization Requirement: H&S 1597.622: 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. The licensee and all adults working with children have proof of immunization.
· Mandated Reporter Training: H&S 1596.8662: Beginning January 1, 2018, all licensed providers, applicants, directors and employees to complete training as specified on mandated reporter duties. Training is available at: www.mandatedreporterca.com
· Liability Insurance was discussed; LPA advised applicant to review Title 22 Regulation 102417(m)(1) for additional information.

Infant Care: Applicant states that they will care for infants. LPA advised the applicant to sleep infants where they can be directly supervised at all times. The applicant states the following as a supervision plan for infants: Applicant states that infants will sleep in the bedroom where she will be providing supervision. Child Care Provider’s Guide to Safe Sleep, by American Academy of Pediatrics online copy can be downloaded at: https://www.cdph.ca.gov/programs/SIDS/Documents/SIDSchildcaresafesleep.pdf

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Armando J Lucero
LICENSING EVALUATOR SIGNATURE:	DATE: 08/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2021

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: CASTRO & EYMAN FAMILY CHILD CARE HOME	FACILITY NUMBER: 198400444
	VISIT DATE: 08/06/2021

NARRATIVE

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

CHILDREN FORMS/RECORDS - Children’s files must contain the following documents/information:
Identification and Emergency Information (LIC 700), Consent for Emergency Medical Treatment (LIC 627), Notification of Parent’s Rights (LIC 995A), Caregiver Background Check Process (LIC 995E), Family Child Care Consumer Awareness Information (LIC 9212), Consent/Verification for Nebulizer Care (LIC 9166), California School Immunization Record, Parent Notification for Additional Children in Care (LIC 9150), Affidavit Regarding Liability Insurance (LIC 282), Acknowledgment of Receipt of Licensing Reports (LIC 9224).

FACILITY FORMS/RECORDS - Facility files must contain the following documents/information:
Personnel Records: As required in Title 22 Regulations 102416.1, Unusual incident/Injury Report (LIC 624B): Child Care Facility Roster (LIC 9040), Notice of Employee Rights (LIC 9052), Statement Acknowledging Requirement to Report Suspected Child Abuse (LIC 9108), Property Owner/Landlord Consent (LIC 9149), Property Owner/Landlord Notification Form (LIC 9149).

INFORMATION TO BE POSTED IN YOU FAMILY CHILD CARE HOME – You are required by Law to post the following:
Facility License (LIC 203), Emergency Disaster Plan (LIC 610A), Earthquake Preparedness Checklist (LIC 9148), Notification of Parent’s Rights (PUB 394). A Notice of Site Visit (LIC 9213): Must be posted for 30 days after each site inspection by a Licensing Representative. Any Licensing Report documenting a Type “A” deficiency must be posted for 30 days during the hours that children are in care. Any Licensing Report or other document verifying compliance or non-compliance with the Department’s order to correct a Type “A” deficiency must be posted for 30 days during the hours that children are in care.

Per applicant, there are no dual licenses at this address.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Armando J Lucero
LICENSING EVALUATOR SIGNATURE:	DATE: 08/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2021

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: CASTRO & EYMAN FAMILY CHILD CARE HOME	FACILITY NUMBER: 198400444
	VISIT DATE: 08/06/2021

NARRATIVE

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LPA also discussed Section 10 of the Application for a Family Child Care Home License:
A. I/We live in the home to be licensed.
B. I/We have money to maintain the level of service required by law in a Family Child Care Home.
C. I/We have both State Fire Marshal approved fire extinguisher (rated 2A, 10BC) and smoke detector in operating condition.
D. I/We shall stay current and in compliance with the law and regulations governing standards for Family Child Care Homes.
E. I/We shall obtain approval from the licensing agency before making changes in our license capacity or to our home.
F. I/We shall notify the licensing agency when we want to discontinue our license.
G. I/We have informed the property owner, if leased or rented, that we will be operating a Family Child Care Home on the premises. The owner/landlord has been sent the Property Owner/Landlord Notification (LIC 9151).
H. I/We have written consent from the property owner, if leased or rented, when I plan to expand my Small Family Child Care Home capacity from 6 to 8 children, or to expand my Large Family Child Care Home capacity to 12 to 14 children. Property Owner/Landlord Consent Form (LIC 9149) has been signed.
I. I/We understand the requirements to report known or suspected child abuse (LIC 9108).
The applicant acknowledges that they have signed the Application for a Family Child Care Home License (LIC 279) under the penalty of perjury that the statements on the application and any attachments are correct.

Based on the LPA’s observation, the fire place needs proper deterrent from children gaining entry. Applicants have until Close of Business day on Friday, August 13, 2021 to submit proof correction to LPA.

There were no deficiencies cited during today's visit in accordance to the California Code of Regulations Title 22, Division 12, Chapter 1.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Armando J Lucero
LICENSING EVALUATOR SIGNATURE:	DATE: 08/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2021

LIC809 (FAS) - (06/04)

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