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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566209273
Report Date: 02/20/2025
Date Signed: 02/20/2025 01:14:16 PM

Document Has Been Signed on 02/20/2025 01:14 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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:LOPEZ FAMILY CHILD CAREFACILITY NUMBER:
566209273
ADMINISTRATOR/
DIRECTOR:		ANGELICA LOPEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 240-1013
CITY:OXNARDSTATE: CAZIP CODE:
93033
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
02/20/2025
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:15 AM
MET WITH:Angelica LopezTIME VISIT/
INSPECTION COMPLETED:
01:40 PM
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On February 20, 2025 11:15 AM, Licensing Program Analyst (LPA) Laura Carone made an unannounced visit to conduct an Annual Required-3 year inspection. LPA met with licensee, Angelica Lpoez and explained the purpose of the inspection. LPA and Licensee toured the interior and exterior of the home. Licensee and an assistant were caring for 6 children at the time of the inspection.

The home is a 3 -bedroom, 3 -bathroom, 1-story home. The licensee uses the playroom, nap room next to playroom, bathroom inside playroom and the backyard for childcare. The 3-bedrooms, 2-bathrooms, and garage are off limits and are inaccessible to children in care. LPA observed age-appropriate toys, teaching materials, and furnishings available for children in care in good condition and free of hazards. Licensee has a secured fence in the backyard. LPA did not observe any toxins/hazardous items accessible to children. A regulation 2A10BC fire extinguisher was observed mounted in the playroom with a service date of 12/04/2024. Licensee is reminded to service or purchase the fire extinguisher yearly. Licensee states that there are no firearms and ammunition in the home. There is a small dog in the backyard. Licensee stated that he is up to date with his immunizations.

LPA observed the home to be orderly. No bodies of water were observed on site. Detergents and cleaning compounds are stored in the garage and a high cabinet in the kitchen keeping items out of reach of children. The bathroom to be used for children in care was observed to be clean. LPA observed a carbon monoxide and smoke alarm detector in the hallway.

Licensee's Pediatric First Aid/CPR certificate is valid until 02/01/2027 and assistant's is valid until 01/06/2026. AB 1207 Mandated Reporter Training certificate for licensee is valid until 06/02/2025 and assistant's is valid until 06/02/2025. Licensee last completed an emergency disaster drill on 01/13/2025. All required forms including Notification of Parent's Rights are prominently posted for parent's or authorized representatives to view.

CONTINUED ON LIC809-C

Lissete GonzalezTELEPHONE: (805) 562-0400
Laura CaroneTELEPHONE: (805) 722-5138
DATE: 02/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/20/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: LOPEZ FAMILY CHILD CARE
FACILITY NUMBER: 566209273
VISIT DATE: 02/20/2025
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A roster of children in care was observed current and complete. All children records were reviewed, and LPA observed Identification and Emergency Notification forms (LIC 700) and a copy of immunization records on file.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process



Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource.

LPA also informed of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment. Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout
CONTINUED ON LIC809-C
SUPERVISOR'S NAME: Lissete GonzalezTELEPHONE: (805) 562-0400
LICENSING EVALUATOR NAME: Laura CaroneTELEPHONE: (805) 722-5138
LICENSING EVALUATOR SIGNATURE:

DATE: 02/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2025
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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: LOPEZ FAMILY CHILD CARE
FACILITY NUMBER: 566209273
VISIT DATE: 02/20/2025
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California. During the exit interview, the licensee, Angelica Lopez, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

No deficiencies cited. A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee, Angelica Lopez. Visit was conducted in Spanish.
SUPERVISOR'S NAME: Lissete GonzalezTELEPHONE: (805) 562-0400
LICENSING EVALUATOR NAME: Laura CaroneTELEPHONE: (805) 722-5138
LICENSING EVALUATOR SIGNATURE:

DATE: 02/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2025
LIC809 (FAS) - (06/04)
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