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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426216419
Report Date: 08/06/2025
Date Signed: 08/06/2025 11:33:09 AM

Document Has Been Signed on 08/06/2025 11:33 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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:RUIZ FCC AKA RUIZ FAMILY DAYCAREFACILITY NUMBER:
426216419
ADMINISTRATOR/
DIRECTOR:		ANGELICA RUIZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 598-9891
CITY:SANTA MARIASTATE: CAZIP CODE:
93454
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 5DATE:
08/06/2025
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:27 AM
MET WITH:Angelica RuizTIME VISIT/
INSPECTION COMPLETED:
11:48 AM
NARRATIVE
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On 08/06/2025, at 8:27AM, Licensing Program Analyst (LPA) Bill Billones conducted an unannounced Required 3 Year inspection of the abovementioned Large Family Child Care Home (FCCH). LPA met with licensee Angelica Ruiz and informed them of the purpose of the inspection. LPA in the company of the licensee toured the interior and exterior of the facility and observed required documents posted in a publicly accessible area of the home. The hours of operation are 5:30 AM to 6:00 PM, Monday through Friday and 6:00 AM to 3:00 PM on Saturday. During the inspection, LPA observed 5 children in care along with the licensee and an assistant providing care and supervision.

The FCCH is a two-story home with 4 bedrooms, 3 bathrooms, kitchen, living/dining room, garage, and an outdoor yard. The FCCH operates out of the living/dining room, kitchen, and 1 bedroom used as a play room, the front yard and part of the backyard. The rest of the home is excluded from child care. LPA observed the living/dining room used for child care was organized and appropriately furnished. LPA observed the play room to contain age-appropriate toys and equipment. LPA observed disinfectants, toxins, and cleaning solutions are stored in an off-limit and locked garage, making them inaccessible to children. LPA advised licensee that cleaning compounds, chemicals, and items that could pose a danger to children should be kept stored in an inaccessible area. LPA observed the kitchen to be accessible to children in care. LPA observed sharps and medications are stored in a high kitchen cabinet shelf. LPA observed the bathroom to be clean for day care children LPA observed door latches on the doors of off-limit rooms, making them inaccessible children in care.

Continued on 809-C.

NAME OF LICENSING PROGRAM MANAGER: Ana Tolentino
NAME OF LICENSING PROGRAM ANALYST: Bill-Brian Billones
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 08/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/06/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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: RUIZ FCC AKA RUIZ FAMILY DAYCARE
FACILITY NUMBER: 426216419
VISIT DATE: 08/06/2025
NARRATIVE
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LPA observed a carbon monoxide detector and a smoke detector, which were both tested at 8:51 AM and found to be operable. LPA observed a fire extinguisher without a service ticket or purchase receipt, which is not in compliance with Title 22 regulations. LPA did not observe an emergency disaster drill log, which licensee states is not maintained. Licensee stated the last emergency drill was conducted in December 2024. The front outdoor yard area is used for childcare is enclosed by metal fencing and latched gates. Outdoor toys are age appropriate. LPA observed 1 small breed dog on the premises, which licensee states vaccines for the animal are up to date. LPA observed animal feces in a section of the backyard, which is accessible to day care children. No children were present in the backyard at the time of inspection, and part of the backyard is fenced and off-limits to the children. Licensee states no firearms or ammunition are stored on site. No bodies of water were observed.

A sample of children's records were reviewed. Children’s files were found to be incomplete. LPA observed 3 out of 5 children’s records were missing the LIC995A receipt in their files. Licensee was also missing the children’s roster, which is not in compliance with Title 22 regulations. Licensee’s Pediatric First Aid/CPR was taken on 08/04/2024. Licensee’s Mandated Reporter training expired on 06/08/2024, which is not in compliance with Health and Safety Code. Licensee was reminded to keep training certifications current and updated prior to expirations. All adults present in the home were associated and cleared on the Guardian facility roster.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Continued on 809-C.

NAME OF LICENSING PROGRAM MANAGER: Ana Tolentino
NAME OF LICENSING PROGRAM ANALYST: Bill-Brian Billones
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2025
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: RUIZ FCC AKA RUIZ FAMILY DAYCARE
FACILITY NUMBER: 426216419
VISIT DATE: 08/06/2025
NARRATIVE
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LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

During today’s inspection, 4 Type B deficiencies were cited under Title 22 California Code of Regulations and Health and Safety Code. 2 Technical Violations were also issued.

A notice of site visit was given and must remain posted for 30 days. Appeal rights were provided.

Exit interview conducted and report was reviewed with the licensees Angelica Ruiz.

NAME OF LICENSING PROGRAM MANAGER: Ana Tolentino
NAME OF LICENSING PROGRAM ANALYST: Bill-Brian Billones
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 08/06/2025 11:33 AM - It Cannot Be Edited


Created By: Bill-Brian Billones On 08/06/2025 at 10:00 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: RUIZ FCC AKA RUIZ FAMILY DAYCARE
FACILITY NUMBER: 426216419

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/06/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(1)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (1) Fireplaces and open face heaters shall be screened to prevent access by children. The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshall.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care.
LPA observed a fire extinguisher that did not have a sevice ticket or a purchase receipt. Licensee acknowleged there was no service ticket or receipt avaliable for review.
POC Due Date: 08/20/2025
Plan of Correction
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Licensee to service existing fire extinguisher or purchase a new regulation fire extinguisher (2A10BC or above). Licensee to submit documented proof of correction to Licensing Program Analyst Bill Billones via email at bill.billones@dss.ca.gov no later than 8/20/2025.
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care.
LPA reviewed staff records and observed licensee's mandated reporter training expired on 6/8/2024.
POC Due Date: 08/20/2025
Plan of Correction
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Licensee and any volunteers and/or employees of the FCCH to renew mandated reporter training and submit certificate(s) to Licensing Program Analyst Bill Billones via email at bill.billones@dss.ca.gov no later than 8/20/2025. LPA advised licensee mandated reporter training must be renewed every two years.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Ana Tolentino
NAME OF LICENSING PROGRAM MANAGER:
Bill-Brian Billones
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 08/06/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/06/2025


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 08/06/2025 11:33 AM - It Cannot Be Edited


Created By: Bill-Brian Billones On 08/06/2025 at 10:00 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: RUIZ FCC AKA RUIZ FAMILY DAYCARE
FACILITY NUMBER: 426216419

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/06/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(8)
Operation of A Family Child Care Home
(8) Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited abovewhich poses a potential health, safety or personal rights risk to persons in care.
LPA requested the children's roster and licensee stated they did not maintain a roster on file.
POC Due Date: 08/20/2025
Plan of Correction
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Licensee to update and maintain a facility children's roster in the FCCH. Licensee to submit documented proof of correction to Licensing Program Analyst Bill Billones via email at bill.billones@dss.ca.gov no later than 8/20/2025.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Ana Tolentino
NAME OF LICENSING PROGRAM MANAGER:
Bill-Brian Billones
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 08/06/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/06/2025


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 08/06/2025 11:33 AM - It Cannot Be Edited


Created By: Bill-Brian Billones On 08/06/2025 at 10:00 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: RUIZ FCC AKA RUIZ FAMILY DAYCARE
FACILITY NUMBER: 426216419

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/06/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102419(d)(1)
Admission Procedures and Authorized Representatives Rights
(d) At the time of acceptance of each child into care, the licensee shall provide the child's parent or authorized representative with a copy of the notice Family Child Care Home Notification of Parent's Rights, LIC 995A (8/06), the Caregiver Background Check Process, LIC 995E (6/05), and the Family child Care Consumer Awareness Information, LIC 9212 (10/05). (1) The licensee shall request the child's parent or authorized representative to sign and date the bottom portion of the notice form LIC 995A (8/06), which acknowledges that the parent or
authorized representative has received and read the LIC 995A. The bottom portion of this form
must be kept in the child’s file as proof that the parent or authorized representative has been
notified of his or her rights and received a copy of the Caregiver background Check Process, LIC
995E (6/05), and the Family Child Care Consumer Awareness Information, LIC 9212 (10/05).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in 3 out of 5 children's files reviewed which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 08/20/2025
Plan of Correction
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2
3
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Licensee to ensure compliance with Title 22 regulations by maintaining required licensing forms or corresponding documentation is kept in each children's file. Licensee to provide a written statement acknowdleding they have read and understand the requirements of Title 22 Regulations and submit to Licensing Program Analyst Bill Billones via email bill.billones@dss.ca.gov no later than 8/20/2025.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Ana Tolentino
NAME OF LICENSING PROGRAM MANAGER:
Bill-Brian Billones
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 08/06/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/06/2025


LIC809 (FAS) - (06/04)
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