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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566211148
Report Date: 10/30/2024
Date Signed: 10/30/2024 11:09:19 AM

Document Has Been Signed on 10/30/2024 11:09 AM - 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:ZAVALA'S FAMILY CHILD CAREFACILITY NUMBER:
566211148
ADMINISTRATOR/
DIRECTOR:		ROCIO ZAVALAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 890-7814
CITY:OXNARDSTATE: CAZIP CODE:
93036
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
10/30/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:36 AM
MET WITH:Rocio ZavalaTIME VISIT/
INSPECTION COMPLETED:
12:55 PM
NARRATIVE
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On October 30, 2024 at 11:36 AM, Licensing Program Analyst (LPA) Aaliyah Zendejas made an unannounced visit for the purpose of conducting a Case Management - Incident inspection. LPA met with Licensee Rocio Zavala to discuss an incident that was self reported to Community Care Licensing Division (CCLD) office by FAX on October 25, 2024. LPA toured the home interior and exterior with the licensee where the incident occurred.

On 10/24/2024 an incident occurred at the daycare at about 11:10 AM. Licensee reported that a child was left unattended and found by people who were from church outside her home. Licensee states during interview that the people from church had knocked, and C1 left the area they were in and opened the door and followed them outside. C1 was found by church people and was left with individuals for about 10 minutes. S2 states during interview that C1 was supposed to be eating but got up and left while S1 was preparing lunch for the children in care. Ratio was 6:2 at the time of incident. Licensee states they had left for a short moment but came back as soon as they heard about the incident.

Licensee states that they had terminated the contact with the child's parents and child is no longer enrolled. To prevent any similar incidents, the licensee has placed locks on the front doors from preventing children from leaving and will be putting cameras in the home. LPA advised licensee to place a gate in the kitchen area.
Due to child being able to have access to front exterior and being left attended by unknown individuals for 10 minutes, one Type B deficiency is being cited today.

A Notice of Site Visit (LIC 9213) was given and must remain posted for 30 days. Appeal Rights were provided to Licensee Rocio Zavala. Exit interview conducted and report was reviewed with the licensee Rocio Zavala.
Lissete GonzalezTELEPHONE: (805) -56-0400
Aaliyah ZendejasTELEPHONE: (805) 722-5133
DATE: 10/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/30/2024
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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Document Has Been Signed on 10/30/2024 11:09 AM - It Cannot Be Edited

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: ZAVALA'S FAMILY CHILD CARE
FACILITY NUMBER: 566211148

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/30/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/13/2024
Section Cited
CCR
102417(a)

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102417 Operation of a Family Child Care Home (a) The licensee shall be present in the home and shall ensure that children in care are supervised at all times... This requirement is not met as evidenced by:
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Licensee is to add a gate prohibiting children from exiting kitchen area and send photo to LPA. Licensee is also to review regulation regarding supervision with assistants.
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Based on interview and record review, the licensee did not comply with the section cited above in which a child was left unattended by daycare staff which poses a potential health, safety or personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Lissete GonzalezTELEPHONE: (805) -56-0400
LICENSING EVALUATOR NAME: Aaliyah ZendejasTELEPHONE: (805) 722-5133
LICENSING EVALUATOR SIGNATURE:
DATE: 10/30/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/30/2024
LIC809 (FAS) - (06/04)
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