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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426216572
Report Date: 01/21/2025
Date Signed: 01/21/2025 11:51:25 AM

Document Has Been Signed on 01/21/2025 11:51 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:MENDOZA FCCFACILITY NUMBER:
426216572
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 1DATE:
01/21/2025
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:50 AM
MET WITH:Celia MendozaTIME VISIT/
INSPECTION COMPLETED:
11:50 AM
NARRATIVE
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On January 21, 2025 at 9:50 AM, Licensing Program Analyst, (LPA) Gigi Reyes conducted an unannounced Case Management inspection at the above address for a change of capacity. During the inspection, the LPA met with applicant/licensee, Celia Mendoza and explained the purpose and scope of the visit.

LPA and applicant, Celia Mendoza toured the interior and exterior of the home. LPA observed that both the interior and exterior specifically the day care areas were free of hazardous materials and/or toxins at the time of the inspection. Fire Extinguisher was serviced on 10/7/2024. LPA observed the carbon monoxide and smoke detectors in the home. Licensee/applicant stated there are no guns or ammunition in the home. Nobodies of water was observed.

On October 9, 2024, Licensees/applicants submitted an application for a change of capacity. The proposed change is to increase the Family Child Care Home's (FCCH) capacity from 8 to 14. Fire clearance was granted on December 5, 2024.

The licensee/applicant provided proof of control of property.


Continued on LIC 809C
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE: DATE: 01/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/21/2025
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: MENDOZA FCC
FACILITY NUMBER: 426216572
VISIT DATE: 01/21/2025
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LPA discussed the safe sleep regulations with applicant, and discussed the Child Care Licensing Safe Sleep webpage at:
htttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep, as an additional resource.

LPA also informed applicant 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.

On this date, 1/21/2025, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

No deficiencies were cited during the inspection. Large FCCH License is granted effective today 1/21/2025


A notice of site visit was given to licensee/applicant and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days

Exit interview conducted and report was reviewed with the licensee/applicant, Celia Mendoza. Report was translate in Spanish by Licensee's daugther, Doriz Mendoza via telephone.

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 01/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2025
LIC809 (FAS) - (06/04)
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