Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197417777
Report Date: 01/14/2016
Date Signed 01/14/2016 02:50:48 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6167 BRISTOL PARKWAY #400
CULVER CITY, CA 90230
FACILITY NAME:CASTILLO & AGUILAR FAMILY CHILD CAREFACILITY NUMBER:
197417777
ADMINISTRATOR:CASTILLO, PATRICIOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 635-5131
CITY:VAN NUYSSTATE: CAZIP CODE:
91406
CAPACITY:14CENSUS: 13DATE:
01/14/2016
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:50 AM
MET WITH:Patricio CastilloTIME COMPLETED:
02:45 PM
NARRATIVE
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Licensing Program Analyst (LPA) Silva Garibyan conducted a site visit for the purpose of an Annual Random visit . LPA met with the licensees and toured the home inside and outside. LPA observed 13 children ( 6 infants, 7 preschool children, no school age children) present at the time of the visit. The facility was operating beyond the limitations of a large Family Child Care ( FCC). This is a single story 4 bedroom, 2 bathroom home. Family members residing in the home include 2 adults and 2 children. Primary areas designated for care are the living room and two bedrooms in the hall way ( the bedroom on the left utilized for a quiet area/napping). Children utilize the living room area for eating only. LPA observed on going construction. Licensee stated that the construction began in May and the estimated completion is in 3 months. The addition to the front of the home has been reported to Community Care Licensing. Licensees state the work is performed on the weekends when children are not in care. Construction debris was observed on the left side of the home, inaccessible to children. Licensee was advised to take additional caution with the children around construction workers and debris. Licensee will complete a new facility sketch once the remodeling is complete. Per licensee, there are no weapons or firearms of any kind in the facility at this time. The LPA did not observe any weapons. There are age appropriate toys and napping equipment on the premises. There is no pool, spa or other bodies of water on the premises. Licensees have 2 assistants ( cleared and associated to the facility). The bathroom was inspected for inaccessibility of chemicals/toxins and other potential hazards to children in care. The kitchen cabinets and drawers were inspected for inaccessibility of toxins/chemicals, knives and other sharp objects which may be harmful to children in care. The Fire Extinguisher (2A-10-BC) is mounted in the living room. There is a working smoke/carbon monoxide detector located in the play room.

SUPERVISOR'S NAME: Mary RuizTELEPHONE: (310) 337-4826
LICENSING EVALUATOR NAME: Silva GaribyanTELEPHONE: (310) 337-3754
LICENSING EVALUATOR SIGNATURE:

DATE: 01/14/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2016
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, 6167 BRISTOL PARKWAY #400
CULVER CITY, CA 90230
FACILITY NAME: CASTILLO & AGUILAR FAMILY CHILD CARE
FACILITY NUMBER: 197417777
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/14/2016
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/14/2016
Section Cited
102416.5 (c)(1)
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Staffing Ratio and Capacity: LPA observed a total of 13 children in care, including 6 infants and no school-age children. Facility is licensed for a maximum of 14 children. Operating beyond the limitations of a license poses an immediate health and safety risk to children in care
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Licensee agrees to reduce her capacity effective immediately. Licensee will submit a current Roster to CCL with the names of the children who are still enrolled at the facility. Licensee will give notices to the parents of the children who will no longer attend care at the facility and submit copies of these letters to CCL by 01/19/2016. POC visit will be conducted to verify compliance
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Mary RuizTELEPHONE: (310) 337-4826
LICENSING EVALUATOR NAME: Silva GaribyanTELEPHONE: (310) 337-3754
LICENSING EVALUATOR SIGNATURE:

DATE: 01/14/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2016
LIC809 (FAS) - (06/04)
Page: 3 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, 6167 BRISTOL PARKWAY #400
CULVER CITY, CA 90230
FACILITY NAME: CASTILLO & AGUILAR FAMILY CHILD CARE
FACILITY NUMBER: 197417777
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/14/2016
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/21/2016
Section Cited
102416(c)
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Personnel Requirements:
Licensee is required to maintain current Pediatric CPR and First Aid certifications at all times.

Licensee was unable to demonstrate current proof of CPR/First Aid Certificates.
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Licensee will provide proof of registration for renewal of Pediatric CPR and Pediatric First Aid certifications by 01/21/2016
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Mary RuizTELEPHONE: (310) 337-4826
LICENSING EVALUATOR NAME: Silva GaribyanTELEPHONE: (310) 337-3754
LICENSING EVALUATOR SIGNATURE:

DATE: 01/14/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2016
LIC809 (FAS) - (06/04)
Page: 2 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, 6167 BRISTOL PARKWAY #400
CULVER CITY, CA 90230
FACILITY NAME: CASTILLO & AGUILAR FAMILY CHILD CARE
FACILITY NUMBER: 197417777
VISIT DATE: 01/14/2016
NARRATIVE
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Licensee was unable to demonstrate current proof of CPR/First Aid Certificates. The First Aid kit was observed, and complete.
LPA observed toys and furniture that were age appropriate and in good repair.
The outdoor play area (back yard) was inspected. Children have plenty of toys to utilize for play.

Licensee has the following documents posted in the FCCH; Facility License (LIC 203), Notification of Parents' Rights Poster (PUB 394) , Child Care Facility Roster (LIC9040), Emergency Disaster Plan (LIC610a).

A review of the children's records was conducted and are found to have the following: LIC 282 Affidavit Liability Insurance, LIC 627/Consent for Medical Treatment, LIC 700/ID and Emergency Information, LIC 995A/Parent's Rights, LIC995E/Caregiver Background Check, LIC 9150/Parent Notification, LIC 9212/Parent's Responsibilities, PM 286/Immunization Card.

"Incidental Medical Services were discussed". Per licensee incidental medical services are not and will not be provided.

One infant and one preschool child was picked up during the visit.

Exit interview was conducted and a copy of the report was provided.
SUPERVISOR'S NAME: Mary RuizTELEPHONE: (310) 337-4826
LICENSING EVALUATOR NAME: Silva GaribyanTELEPHONE: (310) 337-3754
LICENSING EVALUATOR SIGNATURE:

DATE: 01/14/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2016
LIC809 (FAS) - (06/04)
Page: 4 of 4