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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434416004
Report Date: 08/24/2022
Date Signed: 08/25/2022 09:41:09 AM

Document Has Been Signed on 08/25/2022 09:41 AM - 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:CASILLAS, MARIAN & SANDOVAL, JUANFACILITY NUMBER:
434416004
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 5DATE:
08/24/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Marian CasillasTIME COMPLETED:
03:00 PM
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Licensing Program Analyst (LPA) Elizabeth Berumen conducted an unannounced 1 year and increase in capacity inspection. LPA met with Licensee, Marian Casillas and explained the nature of today's visit to her. The inspection was conducted in Spanish. Present during the inspection were 4 day care children and Licensee's 9 and 11 year old children. The adults that reside in the home are the Licensee's (Marian Casillas & Juan Sandoval) and a tenant (Isabella Kass). Licensee's have three minor children ages 14, 11, and 9. Marian states that Isabella Kass will be moving out at the end of the month.

Days and hours of operation will be Monday to Friday from 7:00 am to 6:00 pm. Licensee's have a working telephone (cell phone).
LPA toured the indoor and outdoor areas during today's visit. There are no stairs in the home. LPA observed sufficient materials, toys, and play equipment for the day care children. Off limit areas indoor are rooms 2, 3, 4, kitchen and garage. Poisons, detergents, cleaning compounds, medicines, and other items which could pose a danger if readily available to children are stored where they are inaccessible to children. Licensee was reminded that all poisons are to be locked.
Off limit areas outside are storage sheds (2) and fenced off area. Licensee has an enclosed fenced area that she uses for day care children. No bodies of water were observed. LPA observed a gated cage where Licensee's have two rabbits. Licensee has a dog that is kept on off limit side yard. The backyard is fenced.
LPA Berumen tested the smoke and carbon monoxide detectors both proved to be functioning. The home is equipped with a 2A10BC fire extinguisher. San Jose Fire approved the home on July 12, 2022.
SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Elizabeth Berumen
LICENSING EVALUATOR SIGNATURE: DATE: 08/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/24/2022
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: CASILLAS, MARIAN & SANDOVAL, JUAN
FACILITY NUMBER: 434416004
VISIT DATE: 08/24/2022
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 LPA reviewed 4 children files; are were complete with required forms. Two staff files were reviewed (Marian Casillas and Sonia Marquez. Marian's mandated reporter training was completed on May 18, 2021. Marian and Juan both have current CPR and first aid expiring 03/2023. Sonia has completed the mandated reporter training, has proof of immunization against pertussis, measles and has TB test.

LPA discussed the safe sleep regulations with Licensee 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 Licensee 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.

The Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Supervision of children was discussed with Licensee and she understands that she must be present in the home during day care hours and ensure that the children are supervised at all times. Licensee understands her capacity options and she understands that she cannot have more than 14 children in the home at any time with at least two qualified adults present. Licensee states that does not transport any day care children. Licensee understands that children shall not be left unattended in parked vehicles and that car seats shall only be used for transportation and shall not be used for sleeping.


To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process

Exit interview conducted and report was reviewed with the Licensee, Marian Casillas. No deficiencies issued during today's inspection. A large License (capacity 14) is approved today.

A Notice of Site Visit was given and must remain posted for 30 days.


mariancasillasflores@gmail.com
SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Elizabeth Berumen
LICENSING EVALUATOR SIGNATURE:

DATE: 08/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2022
LIC809 (FAS) - (06/04)
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