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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426210011
Report Date: 12/15/2022
Date Signed: 04/11/2024 11:39:44 AM

Document Has Been Signed on 04/11/2024 11:39 AM - 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:CENDEJAS FAMILY CHILD CAREFACILITY NUMBER:
426210011
ADMINISTRATOR:POMPOSA CENDEJASFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 925-7925
CITY:SANTA MARIASTATE: CAZIP CODE:
93455
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 2DATE:
12/15/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:20 AM
MET WITH:Pomposa CendejasTIME COMPLETED:
10:45 AM
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On December 15, 2022 at 10:20 AM, Licensing Program Analysts (LPAs) Francisca Velazquez and Elvin Baddley conducted an unannounced Case Management - Other inspection for the purpose of delivering the Case Management Office report conducted on December 14, 2022 via Zoom and to gather Licensee's signature on this report. In additions, LPAs inspected the facility to ensure adult son (S1) is no longer living in the residence. LPA met with Licensee, Pomposa Cendejas and advised her the purpose of the inspection. Prior to entering the home LPAs conducted COVID screening questions. Licensee provided LPAs a tour of the garage in the home. There was two (2) children in care at the time of the inspection along with Licensee and Licensee's spouse.

LPAs inspected the facility and note that the bed that was previously located in the garage is no longer in the garage. The garage contains materials that Licensee stated belonged to Licensee.

LPAs and Licensee discussed the criminal record clearance process with Licensee and Licensee acknowledge understanding that S1 can not live or work in the residence until S1's receives fingerprint clearance.

During today's visit no deficiency cited.

Notice of site visit was printed and given and must be posted for the next 30 days. Exit interview was conducted with Licensee, Pomposa Cendejas in Spanish due to Spanish being the Licensee's primary language.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE: DATE: 12/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/15/2022
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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