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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426215865
Report Date: 03/29/2021
Date Signed: 03/30/2021 11:49:28 AM

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:FLORES FAMILY CHILD CAREFACILITY NUMBER:
426215865
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 8DATE:
03/29/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
04:08 PM
MET WITH:Rafael and Blanca FloresTIME COMPLETED:
05:00 PM
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On 3/29/2021, at 4:00 PM, Licensing Program Analyst (LPA) Gigi Reyes conducted an unannounced Case Management Inspection to the facility for Increase of Capacity. Due to COVID-19 and Department of Public Health (DPH) guidelines of social distancing, a tele-inspection will occur. LPA met with Licensee/applicant, Blanca Flores and spouse, Rafael Flores and explained the purpose of the inspection. A tour of the facility inside and outside was conducted. There were eight (8) day care children present at the time of the inspection.

Facility submitted an application to the Community Care Licensing (CCL) requesting an increase in capacity from 8 to 14 day care children. The home is currently utilizing dining area, bedroom 4 converted into day care area and back yard. On 11/24/2020, the Santa Barbara County Fire Department granted a fire clearance to the home.

Issuance of license for Large FCCH is pending upon completion of the following:
  • purchase of new 2 A10BC fire extinguisher or proof of service of the existing one.

A copy of this report was reviewed and provided to the licensee. Licensee agreed to receive a copy of report via email and voiced understanding that the read receipt confirmation from email will be in lieu of their signature once licensee received the report. LPA requested licensee to email a copy of signed form for records.
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi ReyesTELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:

DATE: 03/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2021
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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