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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406216482
Report Date: 05/10/2024
Date Signed: 05/10/2024 12:26:24 PM

Document Has Been Signed on 05/10/2024 12:26 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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:ZACHMANN FAMILY CHILD CAREFACILITY NUMBER:
406216482
ADMINISTRATOR/
DIRECTOR:		ALYCIA ZACHMANN / LEGALFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 458-6089
CITY:ARROYO GRANDESTATE: CAZIP CODE:
93420
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
05/10/2024
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:00 PM
MET WITH:Alycia ZachmannTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
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On 5/10/24, at 12:00PM, at Licensing Program Analyst (LPA) Elvin Baddley conducted an unannounced Case Management Legal/Non-compliance inspection of the abovementioned facility. The purpose of the inspection was to deliver Decision and Order CDSS No. 623340101 (ordered 5/9/24, effective 5/20/24) to Applicant Alycia Zachmann. LPA notes three children (two biological on unrelated) are on site.

LPA provided the Applicant the Decision and Order. LPA discussed the Decision and Order with the Applicant. In essence, the Decision and Order notes the Applicant application for a Family Child Care Home is denied by CCLD. Applicant informed LPA Applicant had received the same document in the mail and Applicant and previously reviewed the document upon reception. LPA informed the Applicant of the ability to appeal the Decision and Order.

LPA exited the premises after provided the Applicant the abovementioned document.


SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE: DATE: 05/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/10/2024
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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