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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434416401
Report Date: 04/13/2023
Date Signed: 04/13/2023 12:24:49 PM

Document Has Been Signed on 04/13/2023 12:24 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:CASTANO, ANGIEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(929) 471-7996
CITY:CUPERTINOSTATE: CAZIP CODE:
95014
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
04/13/2023
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Angie CastanoTIME COMPLETED:
12:30 PM
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Licensing Program Analyst (LPA) Teodoro Trujillo and Licensing Program Manager (LPM) Mary Segura Conducted a scheduled Informal Office meeting at the San Jose Regional Office with Licensee Angie Castano to discuss issues and citations issued on 03/21/2023.

On 03/21/2023, LPA Trujillo arrived 09:37 AM for an annual inspection and observed licensee was alone with 12 children. LPA asked for the ages of children in care. There were four infants and eight preschool age. It was determined licensee was out of ratio without an assistant present. LPA Trujillo asked licensee if an assistant would be helping with children in care, Licensee stated another helper would come to assist in the afternoon. Licensee sister Sandra who is also her assistant, showed up at 9:52 AM, during site visit. LPA observed licensee left the gate open to the childcare room leaving the kitchen accessible to the children in care, a few minutes later she returned with a toy for the children.

LPA observed a can of Lysol, Clorox spray cleaner, cleaning degreaser and a bottle of Dawn soap detergent in the unlocked kitchen sink cabinet, a 2A10BC fire extinguisher last purchased on 07/05/2021 without a yearly service performed. LPA received a roster of the children in care, it was determined that roster was not updated, as child #3 was missing from the roster. LPA observed one sleeping infant in a play yard that did not have a fitted sheet on it. In addition, the door to the room that the infant was sleeping in was open approximately four inches and thereby making it difficult for any adult to visually observe the infant without moving the door.
SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Teodoro Trujillo
LICENSING EVALUATOR SIGNATURE: DATE: 04/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/13/2023
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: 04/13/2023
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LPM Mary Segura, explained that if there are continued serious deficiencies cited against the facility including but not limited to citations for staying in ratio and capacity and hazardous items accessible to children, complying with safe sleep requirements, the licensee may be referred to legal for possible administrative action, which could include revocation of the facility license. The facility will be monitored more frequently to ensure that the facility is maintaining compliance with Title 22 regulations. Licensee Angie Castano was provided a copy of the regulations regarding Staffing Ratio and Capacity, Safe Sleep regulations and maintaining safety equipment including but not limited to fire extinguishers.

LPM Mary Segura discussed the requirement of AB 633 in English and Spanish with Licensee Angie Castano and provided her with the AB 633 fact sheet in English and Spanish and a copy of Acknowledgment of Receipt of Licensing Reports (LIC 9224) and understands the requirements.

Copies of this report dated 04/13/2023 must be provided to Parents/Guardians of children currently in care at this Facility and to the Parents/Guardians of newly enrolled children at the Facility for the next 12 months.
SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Teodoro Trujillo
LICENSING EVALUATOR SIGNATURE:

DATE: 04/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2023
LIC809 (FAS) - (06/04)
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