406216030-9-3-2021-17-CC-FVEZ-C6HU52-20210903151601

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 406216030
Report Date: 09/03/2021
Date Signed: 09/03/2021 03:16:06 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME:	CAZARES FAMILY CHILD CARE		FACILITY NUMBER:	406216030
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 4	DATE:	09/03/2021
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	02:20 PM
MET WITH:	Rocio Lopez Cazares		TIME COMPLETED:	03:33 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 09/03/21, at 2:20 PM, Licensing Program Analyst (LPA) Francisca Velazquez arrived at the facility to conduct an unannounced Case Management inspection of the Family Child Care Home (FCCH). On arrival, Licensee was not home due to picking up children at school. LPA communicated with Licensee who stated she would arrive in about ten (10) minutes from picking up children at school. LPA waited for Licensee to conduct today’s inspection. Licensee arrived to the facility at 2:36 PM. Prior to entering the facility, LPA conducted COVID-19 pre-screening questionnaire and based on Licensee’s responses it was determined that the home is safe and free of any COVID-19 exposures. LPA met with Rocio Lopez Cazares, Licensee of the facility and explained the nature/purpose of the inspection. The Licensee was caring for three (3) children, one (1) was an infant. Licensee's ten (10) year old daughter was also present during inspection. During this inspection, LPA and Licensee together toured the exterior of the FCCH. This FCCH is located inside a mobile park complex, this mobile park complex has a pool accessible to its residents. LPA observed the pool area is completely fenced and inaccessible to children in care. Licensee stated that pool is accessible to residents of the mobile park complex. Pool is usually only open during summer months. Pool is open and closed daily by mobile park complex management. Licensee stated that only the management of the mobile park complex has access to the pool key. Licensee stated that the pool area is not used by children in care. Licensee stated that she is not planning to ever use the pool for children in care.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisca Velazquez	TELEPHONE: (805) 883-8244
LICENSING EVALUATOR SIGNATURE:	DATE: 09/03/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2021

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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: CAZARES FAMILY CHILD CARE	FACILITY NUMBER: 406216030
	VISIT DATE: 09/03/2021

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This Case Management inspection was conducted due to the pre-licensing inspection being conducted via face-time. LPA inspected the pool area to ensure that it is inaccessible to children in care.

LPA observed a pool area in the complex of the mobile park. Pool will not be used by children in care.

This inspection and review of report was conducted in Spanish.

No deficiencies were cited during today’s inspection.

FAILURE TO POST THE NOTICE OF SITE VISIT FOR 30 DAYS MAY RESULT IN A $100.00 CIVIL PENALTY.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisca Velazquez	TELEPHONE: (805) 883-8244
LICENSING EVALUATOR SIGNATURE:	DATE: 09/03/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2021

LIC809 (FAS) - (06/04)

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