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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197495103
Report Date: 06/22/2023
Date Signed: 07/14/2023 11:34:23 AM

Document Has Been Signed on 07/14/2023 11:34 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
EL SEGUNDO CC NORTH, 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: 12TOTAL ENROLLED CHILDREN: 0CENSUS: 4DATE:
06/22/2023
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
MET WITH:IRMA CASTILLO - LicenseeTIME COMPLETED:
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On 06/22/2023 at 1:30 p.m. an office meeting was held via Microsoft Teams held by the El Segundo North Regional Office. In attendance are Victor Bautista, Regional Manager (RM); Emiko Bell, Licensing Program Manager (LPM); Licensing Program Analyst (LPA) Suzette Ornelas. Also in attendance was Irma Castillo, Licensee. Per licensee, she prefers meeting to be held in Spanish.

The purpose of this office meeting is to review the details of the Stipulation and Waiver; and Order which went into effect on May 31, 2023.

RM Bautista informed licensee to ensure staff files are kept readily available as well as the children's roster and to ensure that any unusual incidents are reported to the department via telephone within 24 hours and in writing within 7 days. Licensee is aware that she is to obtain the signed Acknowledgement of Receipt of Licensing Reports LIC 9224 when providing the Stipulation and Waiver; and Order to the parents.

Licensee stated that she is aware of the conditions and that she had an attorney go over the Stipulation and Waiver; and Order. Licensee further stated the she completed the ethics training on June 1, 2023 and obtained a certificate as well as the Family Child Care (FCC) Orientation Certificate. She acknowledges that she will be in compliance with Title 22. Licensee acknowledges that she has received her probationary license.

RM Bautista informed licensee that her license is on probation for 3 years, probation requires a probation monitoring fee which is equal to the annual fee, and is due and payable as soon as possible. Licensee agrees that the probation monitoring fee will be submitted on or before July 15, 2023.

The Regional Office will be conducting more frequent visits. Licensee must comply with all of the conditions as listed on the Stipulation and Waiver; and Order.
SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Suzette Ornelas
LICENSING EVALUATOR SIGNATURE: DATE:
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE:
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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: CASTILLO FAMILY CHILD CARE
FACILITY NUMBER: 197495103
VISIT DATE: 06/22/2023
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Licensee agrees to comply with reporting requirements, informing the department who is residing in her home, criminal background clearance for all residents 18 years and over and record keeping as stated.

Licensee did not have any questions, this report has been translated and read to the licensee in Spanish.

Condition of the Stipulation and Waiver; and Order were reviewed with Irma Castillo - Licensee.
Copy of this report will be provided to Licensee, Irma Castillo via email. Licensee will sign report and return via email by 6/22/2023 by 4:00p.m.
SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Suzette Ornelas
LICENSING EVALUATOR SIGNATURE:

DATE: 06/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/22/2023
LIC809 (FAS) - (06/04)
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