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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197419438
Report Date: 10/17/2024
Date Signed: 10/17/2024 11:49:27 AM

Document Has Been Signed on 10/17/2024 11:49 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:CASTILLO FAMILY CHILD CAREFACILITY NUMBER:
197419438
ADMINISTRATOR/
DIRECTOR:		CASTILLO, CYNTHIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 488-9263
CITY:GRANADA HILLSSTATE: CAZIP CODE:
91344
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 8DATE:
10/17/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:35 AM
MET WITH:Cynthia Castillo, LicenseeTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
NARRATIVE
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Licensing Program Analysts (LPA) Elicia Calvillo conducted an unannounced annual required inspection to the above facility on 10/17/2024. LPA arrived at the facility at 08:35 AM, identified self and met with Cynthia Castillo, Licensee, who guided analyst on a tour of the inside and outside of the facility. There were 8 children present at arrival. Also present was Staff #1 (S1). LPA provided Licensee with a copy of the LIC125 Entrance Checklist to help facilitate the inspection. Facility operation hours are Monday to Friday from 7:00AM to 6:00PM.

The family child care home is one story dueling with a combined living/dining/kitchen Room, 3 bedrooms, and 2 bathrooms. There is a front yard that will be used for dropping off and picking up children. There is a fenced outdoor play area in the back of the house.

LPA observed the following inside areas will be used for child care: living/dining/kitchen room, “Pink” bedroom #2, “Blue” bedroom #3 and bathroom #2 are used for providing care and are accessible to children. Living/dining/kitchen room will be used for dropping off and sleeping and LPA observed cots and bed linens stored in the closet. Bedroom #2 and bedroom #3 will be used for reading, arts and crafts, learning activities, and eating and LPA observed toys and play items that are safe, clean, and appropriate for the ages of the children.

All other rooms are off-limits and made inaccessible by use of safety door locks. There is telephone service via a landline that is used during operation hours.

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SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE: DATE: 10/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/17/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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Page: 1 of 7
Document Has Been Signed on 10/17/2024 11:49 AM - It Cannot Be Edited


Created By: Elicia Calvillo On 10/17/2024 at 11:04 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
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: CASTILLO FAMILY CHILD CARE
FACILITY NUMBER: 197419438

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/17/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, record review, the licensee did not comply with the section cited above in that Licensee and Staff #1 did not have an current Mandated Reporter Training completion certificate readily available upon request which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/18/2024
Plan of Correction
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Per Licencee, Licensee and Staff #1 will complete the Mandated Reporter Training by the plan of correction due date 11/18/2024 and email LPA a copy of the certifcate.
Type B
Section Cited
HSC
1597.622(c)
Administration of Child Day Care Licensing
(c) The family day care home shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person's personnel record that is maintained by the family day care home.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, record review, the licensee did not comply with the section cited above in that the Licensee did not have documentation of required immunizations readily available upon request which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/18/2024
Plan of Correction
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Per Licensee, they will provide documentation of immunizations by the plan of correction due date 11/18/2024 and will email LPA a copy.
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:Rita Ramos
LICENSING EVALUATOR NAME:Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:
DATE: 10/17/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/17/2024


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Document Has Been Signed on 10/17/2024 11:49 AM - It Cannot Be Edited


Created By: Elicia Calvillo On 10/17/2024 at 11:04 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
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: CASTILLO FAMILY CHILD CARE
FACILITY NUMBER: 197419438

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/17/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102370(k)
Criminal Record Clearance
(k) The licensee shall maintain documentation of criminal record clearances or criminal record exemptions of employees, volunteers that require fingerprinting and non-client adults residing in the facility.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation,interview,record review, the licensee did not comply with the section cited above in that Staff #1 was not assoicated to the facility license due to an being removed pending a name change which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/18/2024
Plan of Correction
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Per Licensee, they completed a Criminal Record Transfer request and email to the Regional office to process and LPA obtained a copy of the form and ID for Staff #1.
Type B
Section Cited
HSC
1597.622(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, record review, the licensee did not comply with the section cited above in that Staff #1 did not have documentation of immuizations readily avaiable upon request which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/18/2024
Plan of Correction
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Per Licensee, Staff #1 will obtain documentation of immunizations by the plan of correction due date 11/18/2024 and email LPA a copy.
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:Rita Ramos
LICENSING EVALUATOR NAME:Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:
DATE: 10/17/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/17/2024


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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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: CASTILLO FAMILY CHILD CARE
FACILITY NUMBER: 197419438
VISIT DATE: 10/17/2024
NARRATIVE
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Bathroom #2 located in hallway near bedroom #2 will be used for children. The vanity cabinet holds paper products and no hazards were observed. LPA observed that the bathroom that children will use was safe and sanitary.

Applicant stated that when a child shows signs of an illness the child will isolated away from the other children.



Each bedroom is equipped with a smoke detector and there is one combination smoke/carbon monoxide detector in the hallway near bedroom #2; all were tested and are operable.

There is a working fire extinguisher, the valve on the required 3A 40BC fire extinguisher indicates fully charged and Licensee was not able to confirm last service date.

LPA did not observe any pools, spas, hot tubs, fish ponds, or similar bodies of water during the inspection on the property.

Per Licensee, 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 with the use of a safety latch. Licensee has two dogs and are kept in the bedroom #1 and a fenced outdoor space near the front of the house during the hours of operations.



LPA did not observe a fireplace or an open-faced heater. Per the facility sketch there was a fireplace in the living/dining room that has been removed and Licensee will provide an updated facility sketch. There is a working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort.

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SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2024
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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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: CASTILLO FAMILY CHILD CARE
FACILITY NUMBER: 197419438
VISIT DATE: 10/17/2024
NARRATIVE
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There are currently no infants in care under the age of 12 months. Licensee states that if an infant is enrolled, the infant will sleep in the living room where they are constantly supervised. Infants shall be checked on every 15 minutes and the time of each 15-minute check shall be documented with child’s name and date. The LIC 9227 Individual Infant Sleeping Plan shall be completed for each infant up to 12 months of age and reference Provider Information Notice (PIN) 20-24 CCP.

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.

Licensee was reminded that children in care are to be supervised at all times and made aware that 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 is located on the back yard of the house, is fenced and there are no hazards to children present. LPA observed a climbing structure consisting of two slides, and ladder on an artificial grass surface with padding to absorb falls.

Capacity as specified on the license is being maintained.

LPA reviewed a sample of children’s files and observed files were complete and documented on the LIC857.

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SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2024
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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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: CASTILLO FAMILY CHILD CARE
FACILITY NUMBER: 197419438
VISIT DATE: 10/17/2024
NARRATIVE
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An emergency fire/disaster drill has been completed within the last 6 months (5/24/2024) and the documentation of the fire/disaster drill was not readily available upon request. Licensee’s Mandated Reporter Training was completed on 07/21/2021 and an updated completion certificate was not available upon inspection. Licensee’s pediatric CPR/First Aid expires on 07/2025.

There were 1 personnel record for LPA to review and observed the file was not complete and documented on the LIC 869. Personnel record was missing current Mandated Reporter training certificate and immunization record were not readily available upon request.

All adults who reside or work in the home have a criminal record clearance or exemption. Staff # 1 was removed from the facility roster on 05/02/2024 as they are going through a name change. There are no excluded individuals present at this home.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.



Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.

During the exit interview, the Licensee, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

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SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2024
LIC809 (FAS) - (06/04)
Page: 6 of 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: CASTILLO FAMILY CHILD CARE
FACILITY NUMBER: 197419438
VISIT DATE: 10/17/2024
NARRATIVE
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.Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

The following Type B deficiencies 1596.8662 (b)(1) Mandated Reporter Training, 1597.622 (c) Immunization Records, 1597.622 (a)(1) Immunization Records, and 102370 (k) Criminal Record Clearance and listed on the attached deficiencies page are being cited in accordance with California Code of Regulations Title 22.

A Notice of Site Visit was given and must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to comply with posting requirement will result in an immediate civil penalty of $100.00.



Exit interview was conducted with Cynthia Castillo, Licensee including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role.

PAGE 5 OF 5
SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2024
LIC809 (FAS) - (06/04)
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