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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434416401
Report Date: 06/21/2023
Date Signed: 06/21/2023 03:14:01 PM

Document Has Been Signed on 06/21/2023 03:14 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: 11DATE:
06/21/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Angie CastanoTIME COMPLETED:
03:30 PM
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On 06/21/2023, Licensing Program Analyst (LPA) Teodoro Trujillo met with licensee Angie Castano for a Case Management inspection for the type A deficiency cited on 03/21/2023 and a scheduled Informal Office meeting at the San Jose Regional Office on 04/13/2023 with Licensing Program Manager(LPM) Mary Segura. LPA explained the nature of today's inspection to Licensee. At arrival, Licensee was not home, LPA was greeted by assistant Sandra. LPA observed 10 children, 3 infants and 8 preschool age, with assistants Sandra and Yaquel. Licensee returned later around 1:35 PM.

The child care home is operating within ratio and capacity today. LPA reviewed 14 children's files and observed the LIC 9224 Acknowledgement of Receipt of Licensing Reports with parents' signatures are in each child's file. A copy of the current roster was provided to LPA today.
A listing of staff criminal record clearances associated to this facility in the CCL Licensing Information System (LIS) on 06/21/2023 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.


Exit interview conducted and report was reviewed in Spanish with the 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. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Teodoro Trujillo
LICENSING EVALUATOR SIGNATURE: DATE: 06/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/21/2023
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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