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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 421702142
Report Date: 03/12/2024
Date Signed: 03/12/2024 03:59:59 PM

Document Has Been Signed on 03/12/2024 03:59 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:CAC - GOLETA II CENTERFACILITY NUMBER:
421702142
ADMINISTRATOR:NEENAN, LORRAINEFACILITY TYPE:
850
ADDRESS:5681 HOLLISTER AVENUETELEPHONE:
(805) 967-3637
CITY:GOLETASTATE: CAZIP CODE:
93117
CAPACITY: 38TOTAL ENROLLED CHILDREN: 38CENSUS: 3DATE:
03/12/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:52 PM
MET WITH:Susana Del ToroTIME COMPLETED:
04:00 PM
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On 3/12//2024 at 2:52pm unannounced Case Management inspection was conducted by Licensing Program Analysts (LPAs) German Negrete and Sylvia Ceja who met with Site Supervisor Susana Del Toro. LPAs toured the facility with Site Supervisor. LPAs observed two staff supervising three children.

The purpose for this inspection is to provide the Site Supervisor with a copy of an Accusation for case CDSS No. 7923307003 indicating that Daniela Anahi Cobian(respondent) has been prohibited from employment in, presence in and contact with clients of any facility licensed by the department or certified by a licensed family child care home or any resource family home and from holding a position of member of the board of directors, executive directors or officer of the licensee of any facility licensed by the department for the remainder of respondents life.

LPAs conducted a complete tour of the interior and exterior of the center and did not observe respondent in the facility. Site Supervisor stated that respondent is not employed at this facility.

A copy of the Accusation Summary indicating the Departments decision and summary of factual allegations pertaining to the respondents actions. These findings give the departments Cause for Exclusion. A copy of this accusation shall be provided to the parent/guardian of any currently enrolled child by the next business day or immediately Continued on 809-C

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: German Negrete
LICENSING EVALUATOR SIGNATURE: DATE: 03/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/12/2024
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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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: CAC - GOLETA II CENTER
FACILITY NUMBER: 421702142
VISIT DATE: 03/12/2024
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upon return as well as the parent/guardian of any enrolled child until the accusation is either dismissed or resolved through the administrative hearing or stipulated agreement. The following documentation was provided and explained:

· Accusation


· Acknowledgement of Receipt of Licensing Reports (LIC 9224)
· A copy of the Appeal Rights (LIC 9058 FAS 01/16) were given and explained.
· Site Supervisor signature on this form acknowledges receipt of these rights.

Exit interview conducted with Site Supervisor Susana Del Toro.

Notice of Site Visit (LIC9213) has been posted.



The notice shall be posted for 30 consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty.
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: German Negrete
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2024
LIC809 (FAS) - (06/04)
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