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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566209849
Report Date: 03/13/2023
Date Signed: 03/13/2023 03:43:25 PM


Document Has Been Signed on 03/13/2023 03:43 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:ROBLES FAMILY CHILD CAREFACILITY NUMBER:
566209849
ADMINISTRATOR:LILIA & PATRICIA ROBLESFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 483-6471
CITY:OXNARDSTATE: CAZIP CODE:
93033
CAPACITY:14CENSUS: 0DATE:
03/13/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Lilia & Patricia RoblesTIME COMPLETED:
04:00 PM
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On March 13, 2022 at 2:30 PM Licensing Program Analyst (LPA) Laura Villanueva conducted an unannounced Case Management-Other. LPA met with Licensees, Lilia & Patricia Robles and explained the purpose for the inspection. Prior to entering the facility, LPA asked pre-screening questions related to COVID-19. Responses suggest no COVID exposure on site. Licensees were not caring for children at the present time. The facility is currently on inactive status.

LPA conducted an interview with licensees regarding the criminal record exemption documentation that was sent form Department of Social Services, Care Provider Management Bureau (CPMB) needed for S1. Licensees stated that the LIC300A Confirmation of Removal For S1. documents were completed and scanned to CPMB on 2/24/23. Licensees provided LPA a copy of the completed form LIC300A.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed in Spanish with the licensee, Lilia Robles and English with Licensee, Patricia Robles.

SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Laura VillanuevaTELEPHONE: (805) 722-5138
LICENSING EVALUATOR SIGNATURE:
DATE: 03/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/13/2023
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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