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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426215873
Report Date: 08/23/2021
Date Signed: 08/23/2021 02:49:09 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:CAMARENA FAMILY CHILD CAREFACILITY NUMBER:
426215873
ADMINISTRATOR:NORA A CAMARENAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 621-2428
CITY:SANTA MARIASTATE: CAZIP CODE:
93454
CAPACITY:14CENSUS: 3DATE:
08/23/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:07 PM
MET WITH:Nora CamarenaTIME COMPLETED:
03:03 PM
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Due to COVID-19 pandemic, LPA asked the pre-screening questions prior to inspection. Licensee's responses indicate there was no COVID-19 exposure on site.

On 8/23//21, at 2:07 PM, Licensing Program Analyst (LPA) Martina Jimenez conducted an unannounced Case Management inspection of the above referenced Family Child Care Home (FCCH). LPA met with Nora Camarena, Licensee, and Irene Barba, Licensee's Assistant/daughter of the FCCH and explained the nature/purpose of the inspection.

During this inspection, LPA and Licensee together toured the exterior of the FCCH. LPA observed the FCCH's exterior to be free of hazardous materials and/or toxins at the time of the visit, which would pose a danger to the children in care. The Licensee was caring for 2 children, and 1 infant.

The Case Management inspection was conducted due to when the pre-licensing inspection was conducted, via face-time, the Jacuzzi was inspected to ensure that it is inaccessible to children in care.

LPA observed a jacuzzi in the backyard that is inaccessible to children. Licensee stated that jacuzzi is not in use and has not been in use for a few years. Licensee opened Jacuzzi and LPA observed that there was no water in the Jacuzzi.

LPA reviewed the handout "A Child Care Provider's Guide to Safe Sleep" and Reporting Child Abuse and Neglect. No deficiencies were cited. FAILURE TO POST THE NOTICE OF SITE VISIT FOR 30 DAYS MAY RESULT IN A $100.00 CIVIL PENALTY.
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Martina JimenezTELEPHONE: (805) 387-5041
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2021
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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