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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406216030
Report Date: 04/25/2022
Date Signed: 04/25/2022 12:28:55 PM


Document Has Been Signed on 04/25/2022 12:28 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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117



FACILITY NAME:CAZARES FAMILY CHILD CAREFACILITY NUMBER:
406216030
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 5DATE:
04/25/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Rocio Lopez-CazaresTIME COMPLETED:
12:42 PM
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On April 25, 2022 at 11:50 AM, Licensing Program Analyst (LPA) Francisco Pedroza conducted an unannounced Case Management inspection. LPA met licensee Rocio Lopez-Cazares and advised her the purpose of the inspection. Licensee provided LPA a tour of the home. There were five (5) children in care and one (1) adult assisting at the time of the inspection.

Facility had their annual inspection conducted on 9/17/21. There were no deficiencies cited during the annual inspection. Community Care Licensing (CCL) received an application from licensee on 3/16/22 requesting an increase in capacity. CCL submitted a fire clearance request to Paso Robles Fire Department (PRFD) on 03/16/22. On 3/25/2022 the facility received an approved fire clearance from PRFD. LPA did not observe any concerns during today's inspection.

Effective today April 25, 2022 facility is approved to be a Large Family Child Care with a maximum capacity of 14 children.

THE NOTICE OF SITE VISIT WAS POSTED AS REQUIRED BY H&S CODE SEC. 1596.817
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisco PedrozaTELEPHONE: (805) 689-6267
LICENSING EVALUATOR SIGNATURE:
DATE: 04/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/25/2022
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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