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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426215393
Report Date: 09/29/2022
Date Signed: 09/29/2022 02:47:54 PM

Document Has Been Signed on 09/29/2022 02:47 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:HOUSER FCC AKA LITTLE LIZZY'S DAYCAREFACILITY NUMBER:
426215393
ADMINISTRATOR:ELIZABETH HOUSERFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 332-9690
CITY:SANTA MARIASTATE: CAZIP CODE:
93454
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
09/29/2022
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Elizabeth HouserTIME COMPLETED:
03:00 PM
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On 9/29/22, Licensing Program Analyst (LPA) Elvin Baddley conducted an unannounced Case Management- Legal inspection of the abovementioned Family Child Care Home (FCCH). LPA met with the Elizabeth Houser, Licensee of the FCCH and discussed the purpose of the inspection. LPA notes three children (biological) are present. Further, LPA notes the FCCH is currently on an inactive status until 1/2/23.

The purpose of the inspection was to review and deliver the Decision and Order CDSS No. 7821336002, ordered 9/20/22, and effective 9/30/22, with regard to a denial of a criminal record exemption for Rafael Castellanos. Rafael Castellanos may not reapply for a criminal record exemption for a period of one year from the date 7/8/22.

Licensee notes Rafael Castellanos is a non martial partner and does not reside at the FCCH.

LPA tour the interior and exterior of the FCCH and determined Rafael Castellanos is not employed or present in the facility.


No deficiencies cited during the inspection and a Notice of Site Visit (LIC 9213) as well as Appeal Right (LIC 9058) was provided. The Notice of Site visit must remain posted for 30 days.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE: DATE: 09/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/29/2022
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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