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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426216247
Report Date: 04/02/2024
Date Signed: 04/02/2024 02:12:38 PM

Document Has Been Signed on 04/02/2024 02:12 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:CERVANTES FAMILY CHILD CARE AKA SUNSHINE TOTSFACILITY NUMBER:
426216247
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 4DATE:
04/02/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Engracia CervantesTIME COMPLETED:
02:15 PM
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On 4/2/24 at 12:30 PM, Licensing Program Analysts (LPAs) Francisca Velazquez and Joaquin Mendez conducted an unannounced Case Management Other inspection of the Family Child Care Home (FCCH) for the purpose of ensuring all adults living in the home have criminal record clearance. LPAs met with Engracia Cervantes, Licensee of the FCCH and explained the nature/purpose of the inspection. LPAs notes there were four (4) children present during this inspection being cared for by licensee and Volunteer (S2).

LPAs took a tour of the home, specifically the master bedroom. LPAs observed an empty closet. In the bathroom, LPAs observed hygiene supplies for both male and female.

LPAs interviewed Licensee who reported A2 is not in the home. LPAs asked if A2 was still in the address that was provided to LPAs on the inspection that occurred on 3/27/24. Licensee reported, A2 is no longer in that address and is now staying at Motel 6.

LPAs requested a written declaration from Licensee. Licensee refused to provide a new written declaration as she had already provided one during the inspection that occurred on 3/27/24.

During today's inspection, no deficiency cited. Notice of Site Visit was provided and must remain posted for the next 30 days.

Exit interview and review of report was conducted with Licensee, Engracia Cervantes.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE: DATE: 04/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/02/2024
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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