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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406214149
Report Date: 06/29/2026
Date Signed: 06/29/2026 12:34:13 PM

Document Has Been Signed on 06/29/2026 12:34 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:CAMACHO FAMILY CHILD CAREFACILITY NUMBER:
406214149
ADMINISTRATOR/
DIRECTOR:		BERTHA A. CAMACHOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 238-5261
CITY:PASO ROBLESSTATE: CAZIP CODE:
93446
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 2DATE:
06/29/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:00 PM
MET WITH:Bertha CamachoTIME VISIT/
INSPECTION COMPLETED:
02:00 PM
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On 6/29/26, at 12:00 PM, Licensing Program Analyst (LPA) Matthew Sapien conducted an unannounced annual random inspection of the abovementioned Family Child Care Home (FCCH). LPA met with Bertha Camacho and Arturo Camacho, Licensees of the FCCH, and explained the nature and purpose of the inspection. The LPA, in the company of Licensee's, toured the entirety of the FCCH. The FCCH is a 3-bedroom and 2-bathroom single story residence. The areas that are accessible for day care children is made up of the following: two living rooms (primary play areas), dining room, one bathroom, and the backyard. The remainder of the home, like the garage and bedrooms among other areas, are excluded from childcare services. At the time of the inspection, LPA observed 2 day care children present, 1 of whom was an infant.

LPA observed the FCCH to be clean and orderly. The bathroom utilized for childcare was found to be clean and free of toxins. LPA observed sharps and personal medications in elevated kitchen cabinets, out of reach of children in care. No kids currently require medication. Primary cleaning solutions are stored in the garage in elevated areas.

LPA observed age-appropriate toys, furnishings, and equipment throughout the play areas. In the living room closest to the entrance of the home, LPA observed a locked fireplace. The fireplace is enclosed by glass and Licensees informed LPA that the fireplace is not used during day care hours. In play areas, LPA also observed a storage compartments and containers all of which contain items related to childcare. In the garage and backyard, LPA observed three smaller dogs. Licensee's informed LPA that the dogs are current on their vaccination series and that they don't have interactions with children.

LPA observed relevant licensing forms and documents posted prominently at the entry way of the home. (CONT. 809-C, Page 2)

NAME OF LICENSING PROGRAM MANAGER: Maria Mueller
NAME OF LICENSING PROGRAM ANALYST: Matthew Sapien
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/29/2026
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 4
California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: CAMACHO FAMILY CHILD CARE
FACILITY NUMBER: 406214149
VISIT DATE: 06/29/2026
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LPA observed combination smoke and carbon monoxide detectors within the FCCH. Within the living room closest to the entry, a detector was tested at 12:10 PM and was found to be operational. LPA observed a regulation fire extinguisher in the FCCH which was most recently serviced on 3/25/26. LPA reminded the Licensee's to either service or purchase a regulation fire extinguisher annually. LPA also reviewed the FCCH's fire and earthquake drill log. The most recent disaster drill occurred on 3/16/26. LPA reminded the Licensees of the responsibility of conducting disaster drills at least once every six months. Licensees understood.

As aforementioned, the backyard is accessible to children in care. Along with the Licensee's, the area was inspected by the LPA. The backyard area is fully enclosed by wooden fencing. The fence’s entry and exit gates are secure. The footing of the backyard area is made up of the following: artificial turf, tile, and concrete pavement. Like the interior of the FCCH, childcare toys, structures, and play equipment observed in backyard are age appropriate and are in safe conditions. Shade is afforded by house overhangs. Sun sails were also observed in the backyard that can offer ample shade for children in care. LPA reminded the Licensee's to replace toys and play equipment which start to degrade or are not in good repair. In the yard, LPA observed a couple of locked sheds and other storage compartments all of which contain childcare and common household supplies. Additionally, LPA observed a separate gated area and structure just utilized for the Licensee's dogs. LPA observed no bodies of water throughout the residence and confirmed that this was the case with the providers. LPA reminded the Licensees of active supervision over children in care while engaged in outdoor activities and that the area is inspected prior to letting children outside.

LPA reviewed children's records. The records are current, complete, and possessed emergency contact information and vaccination records, among other relevant licensing documents and forms. The Licensee's records were also reviewed. LPA found that the Licensee's both completed their First Aid/CPR Training (EMSA approved) on 5/19/26 and their Mandated Reporter Training on 6/3/26. Licensee's were reminded to renew certifications and training prior to expirations. Licensee's informed LPA that there are no firearms or ammunition that are present within the residence.

The Licensee's do not currently provide Incidental Medical Services (IMS) or administer medication to children in care. IMS policy was discussed. For IMS information see PIN 22-02CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Homes and the ADA, available at: http://www.ada.gov/childqanda.htm. (CONT. 809-C, Page 3)

NAME OF LICENSING PROGRAM MANAGER: Maria Mueller
NAME OF LICENSING PROGRAM ANALYST: Matthew Sapien
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2026
LIC809 (FAS) - (06/04)
Page: 3 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: CAMACHO FAMILY CHILD CARE
FACILITY NUMBER: 406214149
VISIT DATE: 06/29/2026
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LPA discussed the safe sleep regulations with Licensee's and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed Licensee's of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Licensee's were reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

During today's visit, no deficiencies were issued.

During the exit interview, the Licensee's confirmed that there are no Registered Sex Offenders living in the facility when the LPA completed an RSO profile in FAS on 6/29/26.

A notice of site visit was given and must remain posted for 30 days. Appeal rights were also given and signature on this form acknowledges receipt of these rights. Exit interview was conducted and report was reviewed with the Licensee's, Bertha Camacho and Arturo Camacho.

NAME OF LICENSING PROGRAM MANAGER: Maria Mueller
NAME OF LICENSING PROGRAM ANALYST: Matthew Sapien
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2026
LIC809 (FAS) - (06/04)
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