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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406217619
Report Date: 08/28/2025
Date Signed: 08/28/2025 12:35:41 PM

Document Has Been Signed on 08/28/2025 12:35 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:CAZARES FAMILY CHILD CAREFACILITY NUMBER:
406217619
ADMINISTRATOR/
DIRECTOR:		CAZARES, ROCIOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 835-6190
CITY:PASO ROBLESSTATE: CAZIP CODE:
93446
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
08/28/2025
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:45 AM
MET WITH:Rocio CazaresTIME VISIT/
INSPECTION COMPLETED:
12:50 PM
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This is a change of location, previous facility number 406216030.

On 8/28/25, at 9:45AM, Licensing Program Analysts (LPAs) Seena Parsapour and Matthew Sapien conducted an announced Pre-licensing Inspection of the abovementioned residence and met with Applicant Rocio Cazares. LPAs informed Applicant of the nature and purpose of the inspection. Applicant informed LPAs of the intention to maintain operating hours of a Family Childcare Home (FCCH) from 5:00AM to 10:00 PM, Monday-Friday, and 8:00AM to 9:00PM, Saturday & Sunday. Applicant also intends to care for children 2 months of age to 12 years of age. Applicant was informed that changes in licensing hours and/or the ages of children supervised and cared for can be altered upon notifying CCLD of the given modifications and/or changes. LPAs observed the Licensee’s son, Brandon, age 22, on site at the time of the inspection, as well as the licensee’s granddaughter, age 4. There are 4 adults residing in the home, who have background clearance through The Guardian website, as well as 2 minors residing in the home.



LPAs, in the company of Applicant, toured the interior and exterior of the two-story residence in its entirety. The residence has three (3) bedrooms, three (3) bathrooms, front yard, side yard, back yard, living room & dining area, kitchen & pantry, hallway & laundry area, garage, and closets. The areas to be used for childcare are as follows: living room & dining area, side yard, 1st floor hallway, and 1st floor bathroom. The remainder of the home is excluded from childcare services by way of locked doors, child-safe doorknob covers, and child-safe fencing & latching gates.

· LPAs observed a regulation fire extinguisher (2A10BC) in the area for childcare which was purchased on
NAME OF LICENSING PROGRAM MANAGER: Maria Mueller
NAME OF LICENSING PROGRAM ANALYST: Seena Parsapour
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 08/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/28/2025
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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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: CAZARES FAMILY CHILD CARE
FACILITY NUMBER: 406217619
VISIT DATE: 08/28/2025
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8/20/2025. LPAs reminded Applicant of the responsibility to service or purchase a regulation fire extinguisher annually.
· The residence has a dual smoke & carbon monoxide detector on the 1st floor, which was tested at 10:42AM and found to be operable.
· Near the bathroom, LPAs observed one (1) closet which is free of hazardous items and solely contains brooms & mopping items.
· LPAs observed the residence to be clean and orderly.
· LPAs observed an electric fireplace in the living room secured with a metal & glass front enclosure, preventing access to children in care. Licensee advised that the fireplace has been disconnected from power & placed out of service.
· The residence has space and ventilation for children in care.
· The restroom to be used for children in care is observed to be clean and free of toxins.
· Sharps & medications are in elevated cabinets in the kitchen making them inaccessible to children in care.
· Chemicals and cleaning supplies are stored in elevated cabinets in the hallway area, making them inaccessible to children in care.
· Applicant advised that transportation will be provided for children in care, as well as food, and water by way of individually labeled water bottles.
The side yard is fully fenced by wooden & metal fencing and will be used by FCCH. There is a large gazebo to provide shade for the children’s comfort, in the side yard. The footing consists of concrete pavement. There are toys & play equipment which are in good condition and are age-appropriate for children of various ages. LPAs reminded Applicant to replace play equipment and toys when such items began to degrade or are not in good repair. LPAs note that the side yard, and not the back yard, is accessible to children in care, and is partitioned off from the backyard by way of 5ft tall child-safe metal fencing & latching gate.
· LPAs observed a hot tub in the back yard of the home, which is inaccessible to children in care and features a cover which is in good condition and which can support the weight of an adult.

LPAs' record review revealed Applicant's documents noted below.
· CCLD orientation certification on was obtained on 4/11/2020.

· Applicant completed Preventative Health Training on 8/20/2020.

NAME OF LICENSING PROGRAM MANAGER: Maria Mueller
NAME OF LICENSING PROGRAM ANALYST: Seena Parsapour
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2025
LIC809 (FAS) - (06/04)
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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: CAZARES FAMILY CHILD CARE
FACILITY NUMBER: 406217619
VISIT DATE: 08/28/2025
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· Pediatric CPR/First Aid (EMSA approved) was completed on 6/03/2024 (expiration 6/03/2026).

· Mandated Reporter training was completed on 10/02/2024 (expiration 10/02/2026)


· LPAs reminded Applicant of obligation to maintain current training and certifications.
No prohibited equipment will be allowed or used in the home. No baby bouncers, No infant walkers, No Johnny jumpers, No saucer chairs, No trampolines and any other item that falls into that category are permitted in the facility.

Applicant Rocio Cazares was 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.

The Applicant provided proof of control of property, reflecting property ownership.

Applicant Rocio Cazares states she will not be offering Incidental Medical Services (IMS). Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 2202-CCP. 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 (TW} and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at http://www.ada.gov/childqanda.htm

LPAs reviewed with Applicant, the LIC 311D, Forms/Records to Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist (LIC126) was provided to the applicant.

LPAs discussed the safe sleep regulations with Applicant and discussed the Child Care Licensing Safe Sleep webpage at:
NAME OF LICENSING PROGRAM MANAGER: Maria Mueller
NAME OF LICENSING PROGRAM ANALYST: Seena Parsapour
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2025
LIC809 (FAS) - (06/04)
Page: 4 of 5
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: CAZARES FAMILY CHILD CARE
FACILITY NUMBER: 406217619
VISIT DATE: 08/28/2025
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https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPAs also informed Applicant 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 of infant devices or their purchased equipment.
On this date, 8/28/2025, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility address. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.
Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

On 8/21/2025, the Applicant submitted documentation for a FCCH change of location. The Paso Robles Fire Department granted a fire clearance following an inspection completed at the FCCH on 8/21/2025.

Today, no deficiencies were cited under Title 22 Division 12. Appeal rights were given to Applicant.



The home meets Title 22 of CCR provisional requirements for a Large Family Childcare license. Effective date of license is the present day, 8/28/2025.

A notice of site visit was given to applicant and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Exit interview conducted and report was reviewed with the applicant, Rocio Cazares.


NAME OF LICENSING PROGRAM MANAGER: Maria Mueller
NAME OF LICENSING PROGRAM ANALYST: Seena Parsapour
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2025
LIC809 (FAS) - (06/04)
Page: 5 of 5