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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426216977
Report Date: 01/08/2026
Date Signed: 01/08/2026 04:22:41 PM

Document Has Been Signed on 01/08/2026 04:22 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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:VILLAGOMEZ FAMILY CHILD CAREFACILITY NUMBER:
426216977
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 6DATE:
01/08/2026
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:58 PM
MET WITH:Manuel VillagomezTIME VISIT/
INSPECTION COMPLETED:
04:37 PM
NARRATIVE
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On January 8, 2026 at 1:58 PM, Licensing Program Analyst (LPA) Bill Billones conducted an unannounced Case Management - Change of Capacity inspection at the above-mentioned Family Child Care Home. LPA met with Licensee Manuel Villagomez and discussed the purpose of the inspection. At the time of the inspection six (6) children were present under the care and supervision of the Licensee and an assistant. LPA in the company of the Licensee toured the FCCH. All adults present were associated and cleared.

Licensee utilizes the back living and dining rooms, one half bathroom, one bedroom, and the backyard for childcare services as listed in the facility sketch. Remainder of the home is excluded from care. LPA notes the dining room serves as the feeding room for children and the back living room is primarily used for day care activities and napping. LPA observed an open-faced heater without a cover, which Licensee acknowledged is in working order. LPA observed a fire place and an indoor barbecue grill in the living room, both of which have been covered and are inaccessible to children. One bedroom is used as a play room. LPA observed a gated kitchen where cleaning supplies are elevated and kitchen knives are stored on an elevated counter. LPA reminded Licensee the off-limit areas need to be inaccessible while children are in care. LPA notes pull alarm is located in the dining/kitchen area. LPA advised Licensee that all cleaning compounds should be out of reach of children. The day care bathroom is clean and free of toxins.

LPA observed the backyard to be completely enclosed. LPA observed plenty of space for children's activities. LPA observed that the entry/exit ways are secured with latches and have the ability to be locked. The backyard contains age-appropriate children’s equipment.

Continued on LIC809-C

NAME OF LICENSING PROGRAM MANAGER: Ana Tolentino
NAME OF LICENSING PROGRAM ANALYST: Bill-Brian Billones
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 01/08/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/08/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 4
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: VILLAGOMEZ FAMILY CHILD CARE
FACILITY NUMBER: 426216977
VISIT DATE: 01/08/2026
NARRATIVE
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LPA observed a fire extinguisher that satisfies regulation (3A40BC) with a service tag dated 03/28/2025. LPA reminded Licensee the responsibility to service or purchase a regulation fire extinguisher annually. LPA reviewed Licensee’s Mandated Reporter Training certificate which was completed 10/04/2023 (expired), which is not in compliance with Health and Safety regulations. LPA reviewed Licensee’s Pediatric CPR/First Aid which was completed 06/13/2024. LPA observed smoke alarm and carbon monoxide detectors in the home, which were not tested due to napping children at the time of inspection

Licensee was informed of the MyChildCarePlan.org site, 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.

The Licensee submitted documentation for a FCCH change of capacity. The Licensee is seeking to change the FCCH’s capacity from 8 to 14. The City of Santa Maria Fire Department (SMFD) granted a fire clearance following an inspection completed at FCCH on 12/17/2025. The home is clean and orderly with adequate spacing and ventilation to meet the needs of children in care.

During today's visit, one Type B deficiency is being cited under Health and Safety Code on the attached LIC809-D. One technical violation was also issued.

The home meets Title 22 CCR requirements for a Large Family Child Care license, and the Change of capacity from 8 to 14 children is pending Licensing Program Manager approval.

Exit interview conducted and report was reviewed with the Licensee Manuel Villagomez. Notice of site visit was given.

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

DATE: 01/08/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2026
LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 01/08/2026 04:22 PM - It Cannot Be Edited


Created By: Bill-Brian Billones On 01/08/2026 at 03:52 PM
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: VILLAGOMEZ FAMILY CHILD CARE
FACILITY NUMBER: 426216977

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/08/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/22/2026
Section Cited
HSC
1596.8662(b)(1)

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§1596.8662(b)(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child 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.
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Licensee to submit valid and current training certificate to LPA Billones via email at bill.billones@dss.ca.gov no later than 01/22/2026.
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This requirement was not met as evidenced by LPA's record review of Licensee's Mandated Reporter training certificate expired 10/04/2025, which poses a potential health, safety, and personal rights risks to children in care.
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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: 01/08/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/08/2026


LIC809 (FAS) - (06/04)
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