<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566215681
Report Date: 11/17/2021
Date Signed: 11/17/2021 01:10:12 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:ALVARADO-DIAZ FCC AKA BUENOS DIAZ DAY CAREFACILITY NUMBER:
566215681
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 4DATE:
11/17/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Raquel Alvarado-DiazTIME COMPLETED:
01:30 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On November 17, 2021 at 12:30 PM Licensing Program Analyst, Laura Villanueva conducted an unannounced inspection to complete a Case Management-Licensee Initiated Prior to inspection, LPA Villanueva asked pre screening questions related to COVID-19, Licensee's response indicates there are no COVID-19 exposures on site. LPA toured the home with Licensee, Raquel Alvarado-Diaz. There were 4 children present during inspection.

Licensee is requesting a capacity increase. The Fire Department clearance was granted on 11/10/2021.LPA conducted an annual required inspection today and there were no deficiencies noted. A large license is granted effective today.
SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Laura VillanuevaTELEPHONE: (805) 722-5138
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2021
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 1