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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
566215569
Report Date:
10/18/2019
Date Signed:
10/18/2019 01:08:54 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:
SANTACRUZ FCC AKA ADVENTURES FAMILY CHILD CARE
FACILITY NUMBER:
566215569
ADMINISTRATOR:
FACILITY TYPE:
810
ADDRESS:
TELEPHONE:
CITY:
STATE:
ZIP CODE:
CAPACITY:
8
CENSUS:
2
DATE:
10/18/2019
TYPE OF VISIT:
Case Management - Licensee Initiated
UNANNOUNCED
TIME BEGAN:
11:30 AM
MET WITH:
Maria G. Santacruz
TIME COMPLETED:
12:15 PM
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Licensing Program Analyst LPA Avila made an unannounced visit for the purpose of conducting a Case Management visit per Licensee's request to increase her capacity to a Large Family Child Care Home. LPA Avila met with Licensee Maria Santacruz and discussed the nature and purpose of the facility visit. A fire clearance was issued by the City of Oxnard Fire Department on 10/14/2019.
A license for a Large Family Child Care Home is effective as of today. A new facility license for a Large Family Child Care Home will be issued immediately.
No deficiencies were issued during this facility visit.
SUPERVISOR'S NAME:
George Mingle
TELEPHONE:
(805) 562-0410
LICENSING EVALUATOR NAME:
Michael Avila
TELEPHONE:
(805) 722-5133
LICENSING EVALUATOR SIGNATURE:
DATE:
10/18/2019
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
10/18/2019
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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