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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400498
Report Date: 12/08/2021
Date Signed: 12/08/2021 02:06:31 PM

Document Has Been Signed on 12/08/2021 02:06 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 FAMILY CHILD CAREFACILITY NUMBER:
198400498
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
12/08/2021
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Applicant - Hernan CastroTIME COMPLETED:
02:20 PM
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Licensing Program Analyst (LPA) Randy Derraco conducted an announced pre-licensing inspection to the above mentioned address on 12/08/21 at 10:30 AM. LPA met with applicant, Hernan Castro, who guided LPA on a tour of the home. LPA observed no additional adults or children during inspection. Individuals residing in the home have been discussed and noted. The applicant is requesting a small family childcare home license. Per applicant, operation hours will be seven days a week, 23 hours a day. Applicant states that they will care for children 0 to 13 years old.

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 2 bedrooms, 1 1/2 bathrooms, living room, kitchen, laundry area, front yard, backyard (fenced), and detached garage. An additional living space is attached to the home with the entrance located in the backyard. LPA observed the living space to have a bedroom, kitchen and a bathroom. The room is made inaccessible by a locked door. LPA observed the detached garage to also be converted in to a living space. LPA observed 2 bedrooms, a bathroom and a kitchen area. The detached garage is made inaccessible by a door with a lock and an iron wrought gate. Per applicant, both living spaces will be off limits to children in care.

Main care areas includes the living room and a bedroom. LPA observed the main care area to have two couches, a wall mounted television, a locked entertainment center, a rolling cabinet with toys, a child sized table with chairs, a wooden Lakeshore baby changing station, a Babytrend high chair, a cubby locker for children's personal belongings and a ceiling fan. Upon entry, LPA observed required posting next to the door. Per applicant, parents will enter the facility through the front door where the child's temperature will be taken and pre-screening questions will be asked of the child's health prior to acceptance into care. LPA observed two bathrooms designated for children in care to be clean and free of defects. A child lock was observed beneath sink. Running water and working toilets were observed in both bathrooms. One bedroom (page 1 of 4)

SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE: DATE: 12/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/08/2021
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 4
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 FAMILY CHILD CARE
FACILITY NUMBER: 198400498
VISIT DATE: 12/08/2021
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was observed to be converted into care area for children. LPA observed a Foundations crib with a mattress and fitted sheet, sleeping cots, and additional age appropriate toys and materials. Per applicant, the bedroom will be used to isolate children feeling ill. A wooden gate was observed to separate the main care area from the off-limits kitchen area. No sharp objects were observed to be accessible. Additional child locks were observed on the cabinets in the off-limits kitchen area.

Outdoor play area is located in the back yard. LPA observed the back yard to have perimeter fencing. A wooden fence was observed to separate the outdoor play area from the off-limits backyard area. Age appropriate toys, a tether ball pole mounted to a tire and cement, and two tricycles were observed in the backyard play area. A wooden fence was observed to cover a portion of the house where the tank-less water heater and water meter is kept making the items inaccessible. Per applicant, children will be supervised through the kitchen past the wooden gate in the backyard to access the outdoor play area.

Off limit areas include one bedroom, the kitchen area, a living space attached to the home, the detached garage converted into a living space, a portion of the backyard, and the front yard.



Areas that will be used by children were inspected for safety, comfort, and cleanliness. LPA observed operable telephone service, ventilation and heating (central). Per applicant, detergents, cleaning compounds and hazardous items that can pose a danger to children are kept locked beneath the sink in the off-limits kitchen.

Infant Care: LPA informed applicant of the new Safe sleep regulation and provided PIN 20-24-CCP for when applicant is ready to enroll infants. LPA discussed the safe sleep regulations with applicant 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 applicant 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. LPA advised applicant to download a copy of the Child Care Provider’s Guide to Safe Sleep, by American Academy of Pediatrics at: https://www.cdph.ca.gov/programs/SIDS/Documents/SIDSchildcaresafesleep.pdf

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SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:

DATE: 12/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2021
LIC809 (FAS) - (06/04)
Page: 2 of 4
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 FAMILY CHILD CARE
FACILITY NUMBER: 198400498
VISIT DATE: 12/08/2021
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Per applicant there are no pets in the home. LPA observed firearms to be stored in a locked safe. Ammunition was observed to be stored in a separate locked safe. LPA observed that the Applicant has a 2A10 BC fire extinguisher in the home, and a service tag dated 05/26/21. Smoke and carbon monoxide detector were tested and are operable.

The applicant states that they will provide food for children in care. Any food brought from the children’s homes shall be labeled with child’s name and properly stored or refrigerated.

The applicant has completed the required Health and Safety Training, Nutrition, and Lead Training, Mandated Reporter Training and Pediatric First Aid and CPR. Applicant has proof of required immunization's. There are first aid supplies available.

LPA Provided COVID-19 Technical Assistance by emailing applicant COVID-19 resources and self-assessment prior to visit. LPA discussed self-assessment and answered question regarding COVID-19

Essential Protective Equipment and Supplies- Staff and children (24 months and older) will wear facial coverings throughout the day, excluding meal and nap times (children). Applicant has a contact-less thermometer, disposable gloves, hand sanitizer and disinfectant cleaning supplies in the home.


Cleaning- Per applicant, high touched areas, bathrooms and toys will be disinfected daily or as needed.
Hygiene- Per applicant children will be given hand sanitizer upon entering the home and wash their hands for at least 20 seconds throughout the day. Children will have individual cubbies for their personal belongings.
Arrival Procedures- Per applicant parents will drop off/pick up at the front door. Staff will do daily temperature checks and health screening at the front door, as parents will not be allowed to enter the facility. COVID-19 posters and resources are posted in the front entrance accessible to parents. Parents will be made aware of the COVID-19 policies and exclusion procedures in writing.

Incidental Medical Services (IMS):
This facility may provide Incidental Medical Services – IMS. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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) (page 3 of 4)
SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:

DATE: 12/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2021
LIC809 (FAS) - (06/04)
Page: 3 of 4
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 FAMILY CHILD CARE
FACILITY NUMBER: 198400498
VISIT DATE: 12/08/2021
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and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

LPA advised the applicant how to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov. LPA provided and discussed the following documents: California Child Passenger Safety Law handout (PUB 269), Small Family Chld Care Home Capacity flyer, Protect Your Child From Lead in Paint flyer, Forms/Records to Keep In Your Family Child Care Home (LIC311D), Child Care Facility Roster (LIC 9040), Updates to the Implementation of Guardian (PIN 21-02-CCLD), Recently Approved Safe Sleep Regulations in Effect (PIN 20-24-CCP), LIcensee's, Assistant's, and Children's Files Checklist, Infant Safe Sleep Chart. LPA advised applicant the checklists and infant sleep charts are not resources and cannot be found on the Department website.

The following corrections are needed before a family child care license can be approved:

-Updated LIC 279 indicating adults living in the home
-A completed LIC 9108, LIC 508, and proof of a negative TB test for each adult living in the home

Applicant is requesting a small family child care license. A small family childcare license may be granted upon Licensing Program Manager (LPM) Approval. Once licensed, the applicant is required to comply with the terms and limitations stated on the license.

Exit interview was conducted and report reviewed with applicant.

(page 4 of 4)

SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:

DATE: 12/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2021
LIC809 (FAS) - (06/04)
Page: 4 of 4