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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566215835
Report Date: 09/20/2019
Date Signed: 09/20/2019 12:45:05 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:ZAMORA FAMILY CHILD CAREFACILITY NUMBER:
566215835
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 6DATE:
09/20/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:01 AM
MET WITH:Isa Emma ZamoraTIME COMPLETED:
01:00 PM
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Licensing Program Analyst (LPA) Michael Avila and Elvin Baddley made an unannounced visit for the purpose of conducting a Case Management visit. LPA's met with Licensee Isa Emma Zamora and discussed the nature and purpose of the visit.

LPA's met with the Fire Inspector David Baizan with the Oxnard Fire Department with the purpose of conducting a joint inspection for Licensee's request to increase her capacity for a Large Family Child Care Home facility. LPAs toured the facility with Fire Inspector David Baizan accompanied by Licensee.

Based on the inspection conducted by Fire Inspector Baizan, Licensee was advised take additional action with her escape routes and fire alarm system. Licensee was not approved for the Fire Clearance by the Oxnard Fire Department at this time.

LPA Avila advised Licensee another visit will be conducted pending approval of the Fire Inspection.

No deficiencies were issued at this time.
SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Michael AvilaTELEPHONE: (805) 722-5133
LICENSING EVALUATOR SIGNATURE:

DATE: 09/20/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2019
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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