434410255-7-7-2022-07-CC-AALZ-CG4RYY-20220707132707

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434410255
Report Date: 07/07/2022
Date Signed: 07/07/2022 01:32:15 PM

Document Has Been Signed on 07/07/2022 01:32 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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	CASTRENCE, GAIL		FACILITY NUMBER:	434410255
ADMINISTRATOR:	CASTRENCE, GAIL		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(408) 712-5447
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95148
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 9	DATE:	07/07/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:08 AM
MET WITH:	Castrence, Gail		TIME COMPLETED:	02:00 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 this day Licensing Program Analysts (LPAs) Almaraz, Celi and Trujllo, Ted conducted an annual random inspection. Due to COVID- 19 precautionary measures were taken, licensing staff present during inspection wore appropriate personal protective equipment. LPAs met with Licensee, Castrence, Gail and explained the nature of today's inspection. Present during the inspection was the licensee and assistant Long, Susan. Licensee states that there are currently 11 children enrolled in the Large Family Child Home Day Care. There were nine children present, three infants and three preschool age and two kindergarten. The hours of operation of the day-care are 7:30 AM to 5:30 PM Monday through Friday. There are four adults residing in the home (criminal record clearances on file). Licensee, spouse, Castrence, Larry, adult children Castrance, Larry, Castrance Nicholas and two minor children. Physical Plant: This is a two story home which consists five bedroom and three and half bathrooms. LPAs inspected the indoor and outdoor areas of the home today. Per licensee off limit areas in the home are as follows; Entire upstairs gated, kitchen, the laundry room and garage. Off limit areas outside the home are as follows: The right and left side of back yard, both made in accessible via gate. The backyard is fully fenced. The front yard is safety complaint. The children use two downs stairs bathrooms, one bedroom, living room, dining room and main part of back yard. While the kitchen is off limits, the children have access, thus, LPAs inspected this area and observed it is safety compliant. During this inspection, the following was noted: At 9:08 AM, LPAs began tour through the interior of the home. Areas accessible to children were inspected to ensure that they are clean and orderly with ventilation and central heating for safety and comfort. There were safe toys, play equipment and materials observed for children. LPA did not observe any hazards inside of the home. There is a working telephone service maintained in the home. Detergents, cleaning compounds, medications, and other items which can pose a danger to children are inaccessible. The licensee states that there are no poisons in the home. The licensee does understand that poisons must be locked with a key or combination lock.

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Araceli Almaraz
LICENSING EVALUATOR SIGNATURE:	DATE: 07/07/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2022

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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: CASTRENCE, GAIL	FACILITY NUMBER: 434410255
	VISIT DATE: 07/07/2022

NARRATIVE

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Licensee states that there are no weapons in the home. LPAs did not observe any bodies of water inside or outside the home. Licensee has one pet, vaccinated.

LPAs observed and inspected sleeping equipment for infants. LPAs observed three cribs for each infant who is unable to climb out of the play yard. All equipment meets the US Consumer Product Safety Commission safety standards. Please see www.safekids.org for a list of any recalled products. LPAs observed that cribs are free from loose articles and objects. There was an objects hanging above or attached to the side of the cribs. LPAs observed that play yards do not hinder the entrance or exit to and from the space they are sleeping in. Mattresses were observed to be firm and covered with a fitted sheet that is appropriate to the mattress size. Each infant has their individual bedding and is washed weekly as required. Soiled bedding is replaced when wet or soiled and is placed in an area inaccessible to infants. Pacifiers were observed to not be attached to anything. Licensee was advised that infants shall not be swaddled while in care and all infants up to 12 months should be placed on their back for sleeping.

Facility Records: Licensee and assistant have the following: 1. CPR and First Aid, both valid through 07/01/2023 2. MMR & Tdap vaccinations, as well as opt out for flu vaccine. 3. A current roster. 4. Licensee stated has homeowner’s insurance. 5. Mandated Reporter Training, valid for licensee through 06/01/23, for assistant 11/20/22; both understand this must be renewed every two years.

LPA issued the Children’s Record Review (LIC 857) and the Review of Staff records (LIC 859) to the Licensee during this inspection. LPAs reviewed nine children's files and observed current and updated immunization records and the Family Child Care Home Notification of Parents' Rights forms (LIC 995A) in each file.

Incidental Medical Services (IMS) policy was discussed. Per Licensee there are currently children enrolled who required IMS. 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 keeps epipen for one child, in a locked box, out of reach of children.

LIC 9227 (Individual Sleeping Plan) for infants up to 12 months not in files. Title 22 Regulation Section 102425(j) Infant Safe Sleep was discussed with the Licensee, including but not limited to documentation that shall be maintained. A review of PIN 20-24-CCP Recently approved Safe Sleep Regulations in Effect was discuss and a copy was provided to the Licensee during this inspection.

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Araceli Almaraz
LICENSING EVALUATOR SIGNATURE:	DATE: 07/07/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2022

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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: CASTRENCE, GAIL	FACILITY NUMBER: 434410255
	VISIT DATE: 07/07/2022

NARRATIVE

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Fire and Disaster Safety: LPAs observed a working smoke/carbon monoxide detector, 3A40BC fire extinguisher, last serviced 07/20/2021. LPAs did not observe any heaters in the home. LPs observed a screened fireplace. Fire disaster/earthquake drills last log 07/07/2022.

Supervision: Supervision of the children was discussed; Licensee understands the following: A cleared adult must be present in the home during day care hours. The children must be supervised at all times. The capacity options and ratio requirements. Licensee understands not to leave children in the car unattended. The Licensee states that there is no transporting of children currently.

SB792 (Immunization Requirements for Staff and Employees) was discussed with the Licensee.

The following was discussed:
· 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. Failure to obtain a criminal record background check clearance prior to initial presence in the home will result in an immediate $100.00 dollar or more per day Civil Penalty.
· The Licensee shall be present in the home and shall ensure that children are supervised at all times.
· Children shall not be left in park vehicles.
· The capacity specified on the license shall be the maximum number of children for whom care can be provided.
· Car seats shall only be used for transportation purposes and shall not be used for sleeping.
· All children in care have the right to receive safe, healthful, and comfortable accommodations, furnishings and equipment.
· When a child shows signs off illness, they will be separated from other children until the nature if the illness is determined.

LPAs reviewed and issued the LIC 311 - Forms/Records to Keep in Your Family Child Care Home. CHILDREN’S FORMS/RECORDS, FACILITY FORMS/RECORDS and INFORMATION TO BE POSTED, Disaster drills, posting requirements, children records requirements, mandated child abuse and injury/death reporting, and criminal record transfer requirements were discussed.

LPAs advised the licensee how to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov
At this time, there was one deficiency type B cited during today’s inspection. A notice of site visit was issued and must remain posted for 30 days consecutive days.
Exit interview conducted and report was reviewed with facility representative,

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Araceli Almaraz
LICENSING EVALUATOR SIGNATURE:	DATE: 07/07/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 07/07/2022 01:32 PM - It Cannot Be Edited

Created By: Araceli Almaraz On 07/07/2022 at 11:45 AM

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
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: CASTRENCE, GAIL	FACILITY NUMBER: 434410255
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/07/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102425(c)(2)

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. The Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be maintained in the infant’s file and shall be available to the Department 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 one out of one count. LPAs observed there was no LIC 9227 in any of the infant files, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/15/2022
	Plan of Correction
1 2 3 4	Liceness will email LPA a complete LIC 9227 for all infants in care on or before 07/15/2022, to araceli.almaraz@dss.ca.gov

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:

Diana Stephenson

LICENSING EVALUATOR NAME:

Araceli Almaraz

LICENSING EVALUATOR SIGNATURE:

DATE: 07/07/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2022

LIC809 (FAS) - (06/04)

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