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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198004806
Report Date: 02/18/2022
Date Signed: 02/18/2022 12:18:13 PM

Document Has Been Signed on 02/18/2022 12:18 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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:CASTELLON FAMILY CHILD CAREFACILITY NUMBER:
198004806
ADMINISTRATOR:CASTELLON, ANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 868-4178
CITY:NORWALKSTATE: CAZIP CODE:
90650
CAPACITY: 14TOTAL ENROLLED CHILDREN: 8CENSUS: 4DATE:
02/18/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:38 AM
MET WITH:Licensee Ana CastellonTIME COMPLETED:
12:35 PM
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Licensing Program Analysts (LPA) Jeanette Estrada conducted an unannounced annual required inspection at the above facility on 02/18/22 at 9:38AM. LPA met with Licensee Ana Castellon who guided analyst on a tour of the facility. There were 4 children and 2 staff present when LPA arrived. Facility capacity is in compliance for a Large Family Child Care Home.
This is a one story home which consists of two bedrooms and two bathrooms. Areas used by children are the living room, enclosed patio, playroom, bathroom located in the playroom, front yard. Per licensee, areas off limits to children and parents include: two bedrooms, one bathroom, kitchen, and garage.

Hours of operation are Mon-Fri 6:00 AM - 6:00PM. Food is provided by Licensee. Licensee was reminded if children bring food from home it must be labeled with the child’s name and properly stored or refrigerated.
Individuals residing in the home have been discussed and noted. All adults present in the home have obtained a criminal record clearance or exemption. All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. The following was observed and reviewed during this inspection:
LPA reviewed required posted documentation for Facility License, Publication (PUB) 394- Notification of Parent Rights and Licensing Form (LIC) 9148- Earthquake Preparedness form. Facility records were reviewed for LIC 9040- Facility Roster, LIC 610- Facility Disaster Plan and Disaster drill log, last drill conducted on January 2022. Licensee had a copy of the Roster available during the inspection.
Smoke and carbon monoxide detectors were tested and are operable. Fire extinguisher indicated fully charged and was serviced on 07/2021. The home maintains telephone service cell phone. The home is observed to be clean and orderly. There are toys and other age appropriate materials available for children.

There is an A/C unit available in the playroom and a portable heater is used when needed . Detergents and , cleaning compounds and medication are stored in the off limits kitchen and in the off limit bedroom, inaccessible to children. At the moment there are no children enrolled who require medications .


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SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE: DATE: 02/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/18/2022
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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: CASTELLON FAMILY CHILD CARE
FACILITY NUMBER: 198004806
VISIT DATE: 02/18/2022
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Licensee understands that all poisons must be locked, not only inaccessible to children. Isolation area for sick children waiting to be picked up is in the living room or in the front outdoor area, supervised by an adult and away from the other children. Per Licensee, there are no firearms or weapons stored in the home. There are no pools or spas, or other bodies of water.
Infant Care: Currently licensee cares for 4 infants over 12 months. LPA observed 1 cribs visible in the playroom. Napping equipment does not block entrances or exits. Infant mattresses were observed to be firm with tightly fitted sheets. LPA did not observe loose object, bumpers, objects hanging, or objects attached to the cribs. There are currently no infants with pacifiers. Per licensee wet or soiled sheets are laundered in the facility. Each infant has their own crib/ napping mat and bedding. Only one infant uses a crib. Bedding is washed weekly. LPA informed licensee of the new Safe sleep regulations, including LIC 9227 Infant Sleep Plan for infants under 12 months, 15-minute sleep check documentation for infants 0-24 months, and provided PIN 20-24-CCP. Licensee states the following sleep supervision plan for infants: Infants nap during nap time and are supervised by a staff member
Overnight Care: There is no overnight care provided at the moment. LPA discussed the following: Licensee is aware that they must remain wake while children are awake. If children sleep in separate area from licensee, the door must remain open. If licensee cannot hear children when they wake up, video or audio device can be used.
Currently, children are using the front yard and enclosed patio for outdoor play. The outdoor play area was observed to be fenced. LPA observed that the outdoor yard has toys and other materials for children to play with. LPA's did not observe any objects that could be hazardous to children in care.
Children’s records were reviewed for (LIC) 282- Affidavit Regarding Liability Insurance, Immunizations Records, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights, LIC 9227- Infant sleep form (0-12 months, and documentation of 15-minute Infant Sleep Check (0-24 months)
Staff records were reviewed for approved Pediatric First Aid and CPR certification, LIC-501: Personnel Record, LIC 508-Criminal Record Statement, LIC 9052- Employee Rights, Proof of immunizations against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, LIC 9108- Statement of Child and Mandated Reporter Training Certificate. Licensee's CPR/First Aid expires on 8/2022, Mandated Reporter certificate expires on 8/7/2022
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 02/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2022
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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: CASTELLON FAMILY CHILD CARE
FACILITY NUMBER: 198004806
VISIT DATE: 02/18/2022
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During inspection all children were observed to be treated with dignity and respect, they were observed to be receiving safe, healthful and comfortable accommodations, furnishings and equipment, and free from corporal and/or unusual punishment.
LPA observed that licensee is implementing COVID-19 precautions and procedures.
Incidental Medical Services (IMS):
Incidental Medical Services (IMS) policy was discussed. 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 Center and the ADA, available at: http://www.ada.gov/childqanda.htm
Based on the LPA's observations and records review no deficiencies will be cited today 2/18/22.
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.
LPA discussed the safe sleep regulations with Licensee and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleephttps://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.
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, Ana Castellon. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 02/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2022
LIC809 (FAS) - (06/04)
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