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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 421702142
Report Date: 04/25/2024
Date Signed: 04/25/2024 02:31:51 PM

Document Has Been Signed on 04/25/2024 02:31 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/
DIRECTOR:
NEENAN, LORRAINEFACILITY TYPE:
850
ADDRESS:5681 HOLLISTER AVENUETELEPHONE:
(805) 967-3637
CITY:GOLETASTATE: CAZIP CODE:
93117
CAPACITY: 38TOTAL ENROLLED CHILDREN: 38CENSUS: 3DATE:
04/25/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Susana Del toroTIME VISIT/
INSPECTION COMPLETED:
02:40 PM
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Licensing Program Analysts (LPA) German Negrete conducted an unannounced CASE MANAGEMENT visit to the Child Care Center in order to review the Decision and Order of CDSS No. 7923307003
in regards to the Exclusion for Life of Daniela Anahi Cobian. The Decision and Order is effective 04/22/2024 and is Ordered on 04/10/2024. LPA met with Site Supervisor Susana Del Toro. LPA explained the purpose of the visit. LPA toured the center inside and out. LPA observed 3 Toddlers being supervised by 1 teacher. LPA did not observe Daniela Anahi Cobian in the Center.

Site supervisor stated Daniela Anahi Cobian is not employed or volunteering at this child care center.

Site supervisor stated Danilea Anahi Cobian does not reside in this facility.

LPA provided a copy of the Decision and Order Notice to Site Supervisor.

LPA observed the "Notice of Site Visit" posted.

No deficiencies cited today.

Exit interview was conducted with Susana Del Toro. Appeal Rights were give.

FAILURE TO POST THE NOTICE OF SITE VISIT FOR 30 DAYS MAY RESULT IN A $100.00 CIVIL PENALTY.
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: German Negrete
LICENSING EVALUATOR SIGNATURE: DATE: 04/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/25/2024
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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