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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566215804
Report Date: 12/09/2019
Date Signed: 12/09/2019 11:21:28 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:VILLEGAS FAMILY CHILD CAREFACILITY NUMBER:
566215804
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 5DATE:
12/09/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Carmen Cecilia VillegasTIME COMPLETED:
11:30 AM
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Licensing Program Analysts (LPAs) Betzayra Cervantes and Laura Villanueva made an unannounced visit to conduct a Case Management/Other inspection. The purpose of the visit is to determine the association of A1 to this facility. The Santa Barbara Regional Office received an Registered Sex Offender (RSO) match naming A1 who is not currently linked to this facility. LPAs toured the facility with licensee inside and out. During this inspection, LPAs observed 5 children in care. Licensee was the only adult present during the inspection.

Licensee stated A1 is her brother in law and lives in at a different address. Licensee also stated that A1 is never at the facility or around her day care children. LPAs explained to licensee that A1 is an RSO and the individual's presence in the facility is prohibited at all times according to the California Code of Regulations and California Health and Safety Codes that govern day-care facilities. Licensee voiced her understanding and provided a Declaration stating her understanding that A1 cannot be at this facility or around her day-care children at any time. LPAs also requested a copy of the individual's drivers license to verify residency to be submitted to the Regional Office no later than 12/12/2019. Based on the evidence obtained at today's visit, the LPA has verified that A1 is not present, employed, or residing at the facility.

This report was translated in Spanish by LPA Cervantes. There were no deficiencies cited during today's visit.
SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Betzayra CervantesTELEPHONE: (805) 680-7175
LICENSING EVALUATOR SIGNATURE:

DATE: 12/09/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2019
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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