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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400478
Report Date: 12/23/2021
Date Signed: 12/23/2021 02:43:40 PM

Document Has Been Signed on 12/23/2021 02:43 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 PINEDA & AMAYA FAMILY CHILD CAREFACILITY NUMBER:
198400478
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
12/23/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:20 PM
MET WITH:Co-Applicant Iris Amaya / Ana Castro PinedaTIME COMPLETED:
02:50 PM
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Licensing Program Analyst (LPA) Randy Derraco conducted a case management visit to the above address on 12/23/21 to observe corrections indicated in the pre-licensing inspection. LPA was met with co-applicants Iris Amaya and Ana Castro Pineda. LPA observed Covid-19 self assessment form to be completed with sections that apply to applicants request for a small family child care home. Personal Protective Equipment was observed to be stored on top of a shelf in the main care area. Co-applicant states that arrival procedures will include self assessment questions for the parents regarding children being dropped off as well as temperature checks for all children in care. Co-applicant states that a sanitizing station will be positioned at the front door for children being dropped off for care. LPA observed co-applicants to have drafted a contract to include parent and children expectations when it comes to Covid-19 and slowing its spread in the family child care home. LPA also observed a window mounted heater / air conditioning unit in the main care area. The unit was observed to be above the ground making it inaccessible to children in care.

LPA observed the corrections indicated in the pre-licensing inspection to be completed. A copy of the case management visit report and exit interview was conducted with co-applicants Iris Amaya and Ana Castro Pineda.
SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE: DATE: 12/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/23/2021
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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