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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 073408612
Report Date: 06/28/2023
Date Signed: 06/28/2023 05:29:01 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/28/2023 and conducted by Evaluator Cherie Acosta
COMPLAINT CONTROL NUMBER: 02-CC-20230628102150
FACILITY NAME:CASTILLO-HERNANDEZ, BIANCAFACILITY NUMBER:
073408612
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 6DATE:
06/28/2023
UNANNOUNCEDTIME BEGAN:
04:00 PM
MET WITH:Bianca Castillo-HernandezTIME COMPLETED:
05:30 PM
ALLEGATION(S):
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Provider engaged in a verbal altercation with another adult in the presence of children.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Cherie Acosta conducted an unannounced visit to investigate the above allegation. LPA met with licensee. Also present was the licensee's fingerprint cleared sister/assistant(P3), licensee's fingerprint cleared husband, 3 school aged children, 1 preschool aged child, and one infant in care. Licensee's 2 children of which one child is counted in the ratio were also present.

Licensee admitted that the children in care were playing in the street in the court were licensee lives. Licensee stated that neighbor (P1) drove in the court fast. A different neighbor (P2) asked P1 to slow down as children were playing in the court. A verbal altercation then took place between P1 and the licensee, P2 and P3. The children were present during a portion of the verbal altercation. P3 then took the children inside the home.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Cherie Acosta
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 6
Control Number 02-CC-20230628102150
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: CASTILLO-HERNANDEZ, BIANCA
FACILITY NUMBER: 073408612
VISIT DATE: 06/28/2023
NARRATIVE
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Based on interviews which were conducted, the preponderance of evidence standard has been met, therefore the above allegation is to be substantiated.

The attached type A violation is cited today and must be corrected by the due date. Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. All parents/guardians must sign an acknowledgement form of proof of receiving this report (LIC9224). The LIC 9224 must be placed in the child's file to be reviewed by licensing.

Exit interview and report reviewed with Bianca Castillo-Hernandez
Notice of Site Visit was provided and must be posted for 30 days.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Cherie Acosta
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 6
Control Number 02-CC-20230628102150
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: CASTILLO-HERNANDEZ, BIANCA
FACILITY NUMBER: 073408612
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/28/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/29/2023
Section Cited
CCR
102423(a)(4)
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Personal Rights. Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following:To be free from corporal or unusual punishment, infliction of pain, humiliation,
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Licensee shall review children's personal rights. Licensee shall submit a declaration to CCL ensuring that she understand children's personal rights and shall ensure children's right are not violated.
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intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature, including, but not limited to: interference with eating, sleeping or toileting; or withholding shelter, clothing, medication or aids to physical functioning. This requirement was not met as evidenced by: Licensee engaged in verbal altercation with P1 which is an immediate risk to the health and safety of children in care.
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• Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Cherie Acosta
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2023
LIC9099 (FAS) - (06/04)
Page: 6 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/28/2023 and conducted by Evaluator Cherie Acosta
COMPLAINT CONTROL NUMBER: 02-CC-20230628102150

FACILITY NAME:CASTILLO-HERNANDEZ, BIANCAFACILITY NUMBER:
073408612
ADMINISTRATOR:BIANCA CASTILLO-HERNANDEZFACILITY TYPE:
810
ADDRESS:4009 NICCOLITE CT.TELEPHONE:
(415) 713-0900
CITY:ANTIOCHSTATE: CAZIP CODE:
94509
CAPACITY:8CENSUS: 6DATE:
06/28/2023
UNANNOUNCEDTIME BEGAN:
04:00 PM
MET WITH:Bianca Castillo-HernandezTIME COMPLETED:
05:30 PM
ALLEGATION(S):
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9
Day-Care children play in the street.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Cherie Acosta conducted an unannounced visit to investigate the above allegation. LPA met with licensee. Also present was the licensee's fingerprint cleared sister/assistant(P3), fingerprint cleared husband, 3 school aged children, 1 preschool aged child, and one infant in care. Licensee's 2 children of which one child is counted in the ratio were also present.

Licensee admitted that the children in care were playing in the street in the court were licensee lives. Licensee stated that neighbor (P1) drove in the court fast. A different neighbor (P2) asked P1 to slow down as children were playing in the court. A verbal altercation then took place between P1 and the licensee, P2 and P3. The children were present during a portion of the verbal altercation. P3 then took the children inside the home.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Cherie Acosta
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 6
Control Number 02-CC-20230628102150
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: CASTILLO-HERNANDEZ, BIANCA
FACILITY NUMBER: 073408612
VISIT DATE: 06/28/2023
NARRATIVE
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Based on interviews which were conducted, the preponderance of evidence standard has been met, therefore the above allegation is to be substantiated.

The attached type A violation is cited today and must be corrected by the due date. Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. All parents/guardians must sign an acknowledgement form of proof of receiving this report (LIC9224). The LIC 9224 must be placed in the child's file to be reviewed by licensing.

Exit interview and report reviewed with Bianca Castillo-Hernandez
Notice of Site Visit was provided and must be posted for 30 days.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Cherie Acosta
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 02-CC-20230628102150
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: CASTILLO-HERNANDEZ, BIANCA
FACILITY NUMBER: 073408612
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/28/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/29/2023
Section Cited
CCR
102423(a)(2)
1
2
3
4
5
6
7
Personal Rights. Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following:
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Licensee shall develop a written plan to ensure the children have a safe space for outdoor play. Licensee shall submit this plan to CCL by 6/29/23
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To receive safe, healthful, and comfortable accommodations, furnishings, and equipment. This requirement was not met as evidenced by: Day-care children were allowed to play in the street which poses an immediate risk to the health and safety of children in care.
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Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.
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2
3
4
5
6
7
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Cherie Acosta
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2023
LIC9099 (FAS) - (06/04)
Page: 5 of 6