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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426215280
Report Date: 08/03/2022
Date Signed: 08/03/2022 12:43:28 PM


Document Has Been Signed on 08/03/2022 12:43 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:MR. ROB'S PLACEFACILITY NUMBER:
426215280
ADMINISTRATOR:LAUDERDALE, ROBERTFACILITY TYPE:
840
ADDRESS:434 NOGAL DRIVE, #5TELEPHONE:
(805) 588-7602
CITY:SANTA BARBARASTATE: CAZIP CODE:
93110
CAPACITY:40CENSUS: 0DATE:
08/03/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Robert LauderdaleTIME COMPLETED:
12:57 PM
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On August 3, 2022 at 12:15 PM, Licensing Program Analyst (LPA) Frank Pedroza conducted an announced Case Management inspection. LPA met with Licensee Robert Lauderdale and advised him the purpose of the inspection. Licensee provided LPA a tour of the facility. There was no children in care at the time of the inspection.

Licensee submitted an application on May 16, 2022 to Community Care Licensing (CCL) for an increase from 40 children to 49. On May 16, 2022, CCL submitted a fire request to Santa Barbara County Fire Department for the increase capacity. The facility received an approved fire clearance on May 17, 2022.

The center meets Title 22 Division 12 requirements.

Effective today, August 3, 2022 facility is approved for a capacity of 49 School-age 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: 08/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/03/2022
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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