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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566216144
Report Date: 07/14/2021
Date Signed: 07/14/2021 02:50:47 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:GARCIA FAMILY CHILD CAREFACILITY NUMBER:
566216144
ADMINISTRATOR:GUILLERMINA GARCIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 253-5679
CITY:OXNARDSTATE: CAZIP CODE:
93033
CAPACITY:14CENSUS: 2DATE:
07/14/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Guillermina GarciaTIME COMPLETED:
03:00 PM
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On July 14, 2021 at 1:45 PM Licensing Program Analyst (LPA) Laura Villanueva conducted a Case Management-Other visit. On 7/8/21 LPA conducted a Case Management-Licensee Initiated that should have been a Prelicensing visit. An amendment of the LIC809 is being signed today to reflect the change from Case Management - Licensee Imitated to Prelicensing visit. The previous facility license number is 566215452. A fire inspection was completed on 6/25/21. The Capacity increase from a small family child care to a large family child care was granted as of 7/8/21.

A technical violation was issued for an expired Pediatric First Aid/CPR certificate on the prior visit. Licensee has attended an in person Pediatric First Aid/CPR class on 7/12/21. Licensee has a receipt of the fee paid for the class. Licensee is waiting for certificate to be issued.
SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Laura VillanuevaTELEPHONE: (805) 722-5138
LICENSING EVALUATOR SIGNATURE:

DATE: 07/14/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2021
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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