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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566215509
Report Date: 05/05/2021
Date Signed: 05/05/2021 10:12:38 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:BARCEGA FAMILY CHILD CAREFACILITY NUMBER:
566215509
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 6DATE:
05/05/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Candida BarcegaTIME COMPLETED:
10:15 AM
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On May 05, 2021 at 9:31 AM, Licensing Program Analyst (LPA) Francisco Pedroza conducted an announced tele-visit Case Management inspection. Due to the COVID - 19 and Department of Public Health guidelines of social distancing, a tele-inspection was conducted. LPA met with licensee Candida Barcega and discussed the nature and purpose of the inspection. The tele-inspection was conducted via Zoom. During this tele-inspection the applicant provided LPA a tour of the home inside and out. Licensee had six children in care at the time of the inspection.

Licensee submitted an application to the Community Care Licensing (CCL) requesting to become a large family child care facility on March 16, 2021. On April 27, 2021 the Ventura County Fire Department conducted an inspection. The facility received a fire clearance approval for the large family childcare. A 2A10BC fire extinguisher was observed on the counter in the kitchen with a service date of 07/07/2020. Pediatric CPR and First-Aid certification is current until 3/06/2023. Mandated Reporter training is current until 11/15/2021. Licensee has completed all required licensing requirements to become a large family child care.

Facility license will be a large family childcare effective today, May 5, 2021 for a capacity of 14 children.

A copy of this report was reviewed and provided to the licensees. Licensees 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 she received the report. LPA requested licensee to email a copy of signed form for records.

THE NOTICE OF SITE VISIT WAS POSTED AS REQUIRED BY H&S CODE SEC. 1596.817. THE NOTICE OF SITE VISIT MUST REMAIN POSTED FOR 30 DAYS OR A CIVIL PENALTY OF $100.00 WILL APPLY.

SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisco PedrozaTELEPHONE: (805) 689-4212
LICENSING EVALUATOR SIGNATURE:

DATE: 05/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2021
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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