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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434416401
Report Date: 11/02/2021
Date Signed: 11/02/2021 01:59:10 PM

Document Has Been Signed on 11/02/2021 01:59 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:CASTANO, ANGIEFACILITY NUMBER:
434416401
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 5DATE:
11/02/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:05 PM
MET WITH:Angie CastanoTIME COMPLETED:
02:05 PM
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On 11/02/2021 at 01:05 PM, Licensing Program Analyst (LPA) Susy Cervantes met with licensee, Angie Castano, for an annual inspection and explained the reason for the visit to them. Present during today's visit were licensee with 5 children: 3 infants and 2 preschool. Adults living in the home are licensee with one child age 11. Days and hours of operation are Monday through Friday 8:30 AM to 5:30 PM.

A listing of staff criminal record clearances associated to this facility in the CCL Licensing Information System (LIS) on 11/02/2021 was reviewed and it indicates that all Facility staff or other individuals who require caregiver background clearances have received criminal record and child abuse index clearances or exemptions. 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 inspected inside and outside of the home. LPA observed a covered fire place, no wall heater, no stairs, and no bodies of water. Licensee stated there are no weapons and no pets in the facility. LPA observed a new 2A10BC fire extinguisher. Carbon Monoxide detector and smoke detectors were operable. Sharp objects, medicines, poisons and cleaning supplies are inaccessible to the children and stored under the off limits kitchen sink and garage. Backyard is fenced. Off limit areas: 2 bedrooms, kitchen, family room, garage, left and right side yards. The facility had an annual inspection conducted on 10/14/2021.

A fire department inspection was conducted and clearance was granted on 08/05/2021. LPA reviewed the capacity/ratio for a large Family Child Care Home (FCCH) with Licensee, Angie Castano.


Continues on report dated 11/02/2021 pg. 1/2
SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Susy Cervantes
LICENSING EVALUATOR SIGNATURE: DATE: 11/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/02/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
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: CASTANO, ANGIE
FACILITY NUMBER: 434416401
VISIT DATE: 11/02/2021
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Continuation of report dated 11/02/2021 pg. 2/2

LPA observed a fire and disaster drill log that was last conducted on 06/08/21. LPA observed that the Licensee has Mandated Reporter training, training was completed on 10/18/21. Licensee has Pediatric CPR/1st Aid expiring 11/17/22. Needed documentation for SB 792 which requires immunization against Pertussis, Measles, and Influenza as well as TB testing is on file for licensee, LPA reviewed assistant's immunizations which was in compliance.

Incidental Medical Services (IMS) policy was discussed with the licensee. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The licensee is not providing IMS at this time. Licensee will submit an updated plan of operation if in the future they provide any IMS services to a child in care.

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.


Exit interview conducted and report was reviewed with licensee, Angie Castano. No deficiencies were cited during today's visit. A notice of site visit was given and must remain posted for 30 days. LPA informed licensee that licensure for a Large FCCH is granted pending the following:

-Management's approval
SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Susy Cervantes
LICENSING EVALUATOR SIGNATURE:

DATE: 11/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2021
LIC809 (FAS) - (06/04)
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