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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 243911165
Report Date: 12/20/2021
Date Signed: 12/20/2021 03:54:39 PM

Document Has Been Signed on 12/20/2021 03:54 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, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:CASTELLANOS, EMILCE FAMILY CHILD CAREFACILITY NUMBER:
243911165
ADMINISTRATOR:CASTELLANOS, EMILCEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 858-7356
CITY:LOS BANOSSTATE: CAZIP CODE:
93635
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
12/20/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Emilce CastellanosTIME COMPLETED:
04:15 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
On 12/20/2021 Licensing Program Analyst (LPA) Robert Gutierrez, conducted an unannounced Annual Required Inspection and was met by Licensee, Emilce Castellanos. Staff #1 (S1) arrived at the facility at around 11:45 AM. Licensee is Spanish Speaking and S1 assisted with interpretation. Days and hours of operation are Monday – Friday 5:00 AM – 10:00 PM and Saturday – Sunday 7:00 AM – 5:00 PM.

LPA toured the home inside and outside and a census was taken. Current facility sketch reviewed and licensee confirmed that the day care room, living room, dining room, kitchen and backyard are used for providing care and are accessible to children. Inspecting the backyard LPA observed a play structure securely anchored to the ground and a storage shed that was locked. Inspecting other areas of the facility, LPA observed Child #4 sleeping inside a play yard that contained several blankets and pillows. In addition, the bedroom in which Child #4 was sleeping in is marked as off-limits on the facility sketch. LPA inspected the off-limits bedroom but did not see any potential hazards. Licensee removed Child #4 from the bedroom locked the door, and placed him/her in an accessible daycare area. LPA did not inspect kitchen drawers as they contained properly functional preventative entry devices on them. Swimming pool is fenced per regulation. The pool gate is self-latching, self-closing and opens away from the swimming pool. No windows or doors have direct access to the pool area. There are no firearms or ammunition on the premises. No poisons were observed during the inspection. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible.

There are no fireplaces or open face heaters in the home. There is a working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort. Stairs are fenced or barricaded when children under age 5 years old are present. Safe toys and play equipment are observed. The home has working telephone service and LPA confirmed the phone number is (408) 858-7356.

Continued on 809-C

SUPERVISORS NAME: Susie Fanning
LICENSING EVALUATOR NAME: Robert Gutierrez
LICENSING EVALUATOR SIGNATURE: DATE: 12/20/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/20/2021
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 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: CASTELLANOS, EMILCE FAMILY CHILD CARE
FACILITY NUMBER: 243911165
VISIT DATE: 12/20/2021
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
There are currently four infants in care. LPA discussed Safe Sleep Regulations with licensee. There is one crib or play yard for each infant in care. Cribs and play yards are not kept free from all loose articles and objects while infants are sleeping. There are no objects hanging above or attached to the crib or play yard. Infants are not swaddled while in care. Provider physically checks on sleeping infants every fifteen minutes and documents any signs of distress which includes but is not limited to flushed skin color, increase in body temperature, restlessness and labored breathing. Child #4 was sleeping in an off-limits bedroom with the door closed. Licensee was made aware when an infant is sleeping in a different room, the door must remain open. Individual Infant Sleeping Plan is not completed for children 12 months of age. Infants up to 12 months of age are placed on their backs for sleeping.

Licensee ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children. The outdoor play area in the backyard is fenced and there are no hazards to children present. Upon inspection LPA was greeted by licensee. LPA took census and counted a total of 9 children present. Licensee stated her assistant just left to the store and that was the reason on why she was over capacity/ratio. S1 arrived at the facility and capacity/ratio were in compliance.

LPA reviewed a sample of children’s files and observed files were complete with emergency information as required. Licensee has a current roster of children in care. Licensee’s Mandated Reporter Training was completed on 08/31/2020. Licensee’s pediatric CPR/First Aid expires on 06/12/2023. A review of records indicates that all employees and/or volunteers have immunization records on file for influenza, pertussis and measles.

All adults who reside or work in the home have a criminal record clearance or exemption. There are no excluded individuals present at this home.

Incidental Medical Services (IMS) are not currently being provided. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.



Continued on 809-C
SUPERVISORS NAME: Susie Fanning
LICENSING EVALUATOR NAME: Robert Gutierrez
LICENSING EVALUATOR SIGNATURE:

DATE: 12/20/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2021
LIC809 (FAS) - (06/04)
Page: 2 of 6
Document Has Been Signed on 12/20/2021 03:54 PM - It Cannot Be Edited


Created By: Robert Gutierrez On 12/20/2021 at 01:57 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
, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: CASTELLANOS, EMILCE FAMILY CHILD CARE
FACILITY NUMBER: 243911165

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/20/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(a)(3)
Infant Safe Sleep
(a) There shall be one crib or play yard for each infant who is unable to climb out of the crib or play yard. (3) Mattresses shall be firm and covered with a fitted sheet that is appropriate to the mattress size, fits tightly on the mattress, and overlaps the underside of the mattress so it cannot be dislodged.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, the licensee did not comply with the section cited above. LPA observed several play yards that did not contain a tight fitting sheet. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/04/2022
Plan of Correction
1
2
3
4
Licensee stated she shall purchase a tight fitting sheet for these play yards. Proof of this correction shall be submitted by the given due date.
Type B
Section Cited
CCR
102425(b)
Infant Safe Sleep
(b) Cribs or play yards shall be free from all loose articles and objects.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, the licensee did not comply with the section cited above. LPA observed Child #4 sleeping in a play yard that contained several blankets and pillows. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/03/2022
Plan of Correction
1
2
3
4
During inspection, licensee removed these items from the play yard. Licensee then agreed to attend a safe sleep meeting to ensure she understands safe sleep regulations. Licensee shall submit a written statement saying she has attended this meeting.
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:Susie Fanning
LICENSING EVALUATOR NAME:Robert Gutierrez
LICENSING EVALUATOR SIGNATURE:
DATE: 12/20/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/20/2021


LIC809 (FAS) - (06/04)
Page: 3 of 6
Document Has Been Signed on 12/20/2021 03:54 PM - It Cannot Be Edited


Created By: Robert Gutierrez On 12/20/2021 at 01:57 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
, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: CASTELLANOS, EMILCE FAMILY CHILD CARE
FACILITY NUMBER: 243911165

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/20/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416.3(a)(6)
Alterations to Existing Building or Grounds
(a) Prior to making alterations or additions to a family child care home or grounds, the licensee shall notify the Department of the proposed changed, including, but not limited to, the following: (6) Any change from an area of the family child care home previously identified as "off limits" to an area where care and supervision will be provided to children in care.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, the licensee did not comply with the section cited above in she had Child #4 sleeping in a play yard containing several blankets and pillows in an off-limits bedroom. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/20/2021
Plan of Correction
1
2
3
4
Licensee removed Child #4 from the bedroom and placed him/her in an accessible bedroom.

Cleared during todays inspection.
Type B
Section Cited
CCR
102425(c)
Infant Safe Sleep
An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 months of age the provider has in care and included in the infant's file at the facility.

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 that Child #4 did not have the LIC 9227 form on file. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/27/2021
Plan of Correction
1
2
3
4
Licensee shall have the legal guardian of Child #4 sign and complete this form. Proof of this correction shall be submitted to the Fresno Regional office by the given 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:Susie Fanning
LICENSING EVALUATOR NAME:Robert Gutierrez
LICENSING EVALUATOR SIGNATURE:
DATE: 12/20/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/20/2021


LIC809 (FAS) - (06/04)
Page: 4 of 6
Document Has Been Signed on 12/20/2021 03:54 PM - It Cannot Be Edited


Created By: Robert Gutierrez On 12/20/2021 at 01:57 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
, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: CASTELLANOS, EMILCE FAMILY CHILD CARE
FACILITY NUMBER: 243911165

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/20/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416.5(a)
Staffing Ratio and Capacity
(a) The capacity specified on the license shall be the maximum number of children for whom care may be provided at any one time.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, the licensee did not comply with the section cited above in that she was caring for 9 children by herself. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/04/2022
Plan of Correction
1
2
3
4
Licensee contacted Staff #1 and she arrived at the facility to make sure the ratios/capacity were in compliance. Licensee agreed to watch a CCL video pertaining to ratios/capacity. Once the video is watched the licensee shall submit a written statement saying she watched the video.
Section Cited
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:Susie Fanning
LICENSING EVALUATOR NAME:Robert Gutierrez
LICENSING EVALUATOR SIGNATURE:
DATE: 12/20/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/20/2021


LIC809 (FAS) - (06/04)
Page: 5 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: CASTELLANOS, EMILCE FAMILY CHILD CARE
FACILITY NUMBER: 243911165
VISIT DATE: 12/20/2021
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
LPA and Licensee discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiencies are being cited: (see next page, 809 D) Licensee was provided a copy of appeal rights.

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.

SUPERVISORS NAME: Susie Fanning
LICENSING EVALUATOR NAME: Robert Gutierrez
LICENSING EVALUATOR SIGNATURE:

DATE: 12/20/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2021
LIC809 (FAS) - (06/04)
Page: 6 of 6