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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197495103
Report Date: 05/05/2022
Date Signed: 05/05/2022 10:30:43 AM

Document Has Been Signed on 05/05/2022 10:30 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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:CASTILLO FAMILY CHILD CAREFACILITY NUMBER:
197495103
ADMINISTRATOR:IRMA CASTILLOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 841-0852
CITY:BURBANKSTATE: CAZIP CODE:
91505
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
05/05/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Irma CastilloTIME COMPLETED:
11:00 AM
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On 5/5/2022, Licensing Program Analyst (LPA) Lillian Casillas conducted an announced Pre-Licensing Inspection for a Change of Location from 1606 N. Rose Street, Burbank, CA 91505 to 1925 N. Kenwood Street, Burbank, CA 91505. LPA met with Licensee, Irma Castillo, who guided LPA on a tour of the inside and outside of the home. LPA observed 0 children in care. Hours of operation are scheduled for Monday through Friday, 7:00AM to 6:00PM.

Applicant is applying for a Large Family Child Care Home with maximum capacity of 14 children, ages 3 months to 10 years old.

This is a single-story home with 3 bedrooms, 2 bathrooms, 2 living rooms, dining room, kitchen, laundry room, garage, front yard, and backyard. Childcare areas are: living room 1, living room 2, dining room, kitchen, bedroom 2, and bathroom 1. Off-limits areas are: bedroom 1, bedroom 3, bathroom 2, laundry room, garage, front yard, and backyard.

Indoor


LPA entered the home through the front door that leads into living room 1, which Applicant stated is the primary child care area. In living room 1, LPA observed a parent board on the wall at the entrance with Emergency Disaster Plan, Notification of Family Child Care (PUB394), If You See Something, Say Something poster, fire safety drill log, and a space for the License. LPA also observed age-appropriate toys and books, cubbies, 1 children's table with 6 chairs, 1 couch, 1 high chair, 1 changing table, 6 cots, fire alarm, and a functioning smoke/carbon monoxide detector. Bathroom 1 can be accessed via the hallway. In bathroom 1, LPA observed 1 toilet, 1 sink, 1 bath/shower, hand washing poster, and paper towels. All shampoos and soaps are stored in a high ledge in the shower. Bedroom 2 can be accessed via the hallway. In bedroom 2, LPA observed 1 full-sized bed and 1 crib. Applicant stated she plans on providing care for no more than 1 infant. The kitchen can be accessed via the hallway. In the kitchen, LPA observed child safety latches on all lower cabinet doors. Applicant stated she provides lunch for children. [CONTINUE ON PAGE 2]
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Lillian J Casillas
LICENSING EVALUATOR SIGNATURE: DATE: 05/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/05/2022
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 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: CASTILLO FAMILY CHILD CARE
FACILITY NUMBER: 197495103
VISIT DATE: 05/05/2022
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In the dining room, LPA observed 1 dining table with 4 chairs. In living room 2, LPA observed 1 mounted TV, 1 sectional sofa, 2 refrigerators, and 1 desk. Licensee stated children will use this room to watch movies.

LPA discussed Child Care Resource Center, the local Resource & Referral agency, with Licensee to inquire about food programs, child care referrals, and professional development training. Connections for Children contact information: (818) 717-1000 ext. 4714, https://www.ccrcca.org/



Indoor Off-Limits
LPA observed key locks on the doors of bedroom 2, bedroom 3, and bathroom 2. Licensee agreed to secure a child safety gate to block off the laundry room. The serviced (February 2022) 2A10:BC fire extinguisher is located in the laundry room.

Outdoor
LPA observed a large backyard. In the shaded patio area, LPA observed a children's power car, age-appropriate toys, and a children's table with 6 chairs. LPA also observed two dog crates enclosed by a gate where Licensee keeps her two dogs. LPA reviewed dogs' vaccination records. LPA informed Licensee of the best practice to not commingle children her the dogs. In the grassy area, LPA observed 1 slide/swing set in good condition and secured to the ground, and 1 shed that is locked and inaccessible to children.

Outdoor Off-Limits
Licensee stated the garage and front yard are off-limits. The garage can be accessed via two doors with keys locks in the patio and in living room 2.

Licensee states there are no firearms or weapons of any kind in the facility at the time of the visit. LPA observed all electrical outlets covered in on-limits areas of the home. LPA observed a first-aid kit located in living room 2 on top of the refrigerator. Isolation area is located in living room 2.

[CONTINUE ON PAGE 3]

SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Lillian J Casillas
LICENSING EVALUATOR SIGNATURE:

DATE: 05/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2022
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: CASTILLO FAMILY CHILD CARE
FACILITY NUMBER: 197495103
VISIT DATE: 05/05/2022
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Criminal Record Statement
Licensee was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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.

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: http://www.ada.gov/childqanda.htm

Safe Sleep


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 Applicant 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
Exit interview conducted and report was reviewed with Licensee, Irma Castillo.

Family Child Care Homes
LPA reviewed with Licensee the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the Licensee.

[CONTINUE ON PAGE 4]

SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Lillian J Casillas
LICENSING EVALUATOR SIGNATURE:

DATE: 05/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2022
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: CASTILLO FAMILY CHILD CARE
FACILITY NUMBER: 197495103
VISIT DATE: 05/05/2022
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Subscribe to CCLD important information
Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

LPA advised Licensee to call (424) 301-3077 and speak with the Office On Duty for any questions about regulations until she is assigned a LPA.

SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Lillian J Casillas
LICENSING EVALUATOR SIGNATURE:

DATE: 05/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2022
LIC809 (FAS) - (06/04)
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