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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426217151
Report Date: 01/29/2026
Date Signed: 01/29/2026 02:21:26 PM

Document Has Been Signed on 01/29/2026 02:21 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:GIJON FAMILY CHILD CAREFACILITY NUMBER:
426217151
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 2DATE:
01/29/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:00 PM
MET WITH:Heliodora Gijon CarmonaTIME VISIT/
INSPECTION COMPLETED:
02:45 PM
NARRATIVE
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On January 29, 2026, at 12:02PM, Licensing Program Analyst (LPA) Joaquin Mendez conducted an unannounced Annual/Random inspection of the above-mentioned Family Child Care Home (FCCH). LPA met with Heliodora Gijon Carmona, Licensee of the FCCH. LPA Mendez explained the purpose of the inspection. The licensee submitted an update LIC279 and LIC999. The licensee intends to include bedroom 3 from the LIC999 for daycare use. LPA notes two (2) children are present at the time of inspection and one of the children is an infant. At 12:10 PM the LPA notes the infant is napping in the playpen surrounded by stuffed animals and blankets.

LPA in the company of the Licensee toured the interior and exterior of the FCCH. The main day care areas are living room, hall bathroom, dining room, kitchen, bedroom 3 and backyard. LPA observed the day care areas to be clean and orderly. LPA observed age-appropriate books, toys, games, tables and chairs. LPA observed the off-limits areas which include the two (2) bedrooms to be secured preventing access. The garage which is converted into the licensee’s master bedroom is locked and inaccessible.

The FCCH is clean, orderly, and has ventilation to afford for the children’s comfort. Sharps and cleaning supplies are stored in an elevated cabinet. The licensee states she keeps medications locked in her bedroom and are inaccessible. The bathroom was observed to be clean. However, at 12:47PM the LPA observed shampoo and conditioner in the shower where children have access. The Licensee stated her daughter had just showered and forgot to place the items back in their secure location. At the time of inspection, the children in care are too small to reach the area where the shampoos were found. The licensee immediately moved the items to a secure location and are inaccessible.

Continue on LIC809C

NAME OF LICENSING PROGRAM MANAGER: Maria Mueller
NAME OF LICENSING PROGRAM ANALYST: Joaquin Mendez
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 01/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/29/2026
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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Document Has Been Signed on 01/29/2026 02:21 PM - It Cannot Be Edited


Created By: Joaquin Mendez On 01/29/2026 at 01:18 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: GIJON FAMILY CHILD CARE
FACILITY NUMBER: 426217151

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/29/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(4)
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: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children.

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 in shampoo and conditioner were found in the bathroom accessible to children which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/10/2026
Plan of Correction
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Licensee to submit to CCLD by 2/10/2026, verification of correction (photos) as well as written statement noting plan of correction to prevent future occurrences. A business card with contact information is provided to the licensee.
Type B
Section Cited
CCR
102425(b)
Infant Safe Sleep
(b) Cribs or play yards shall be free from all loose articles and objects.

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 in infant was napping surrounded by stuffed toys and blankets which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/10/2026
Plan of Correction
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Licensee to submit to CCLD by 2/10/2026, verification of correction (photos) as well as written statement noting plan of correction to prevent future occurrences. A business card with contact information is provided to the licensee.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Maria Mueller
NAME OF LICENSING PROGRAM MANAGER:
Joaquin Mendez
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 01/29/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/29/2026


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: GIJON FAMILY CHILD CARE
FACILITY NUMBER: 426217151
VISIT DATE: 01/29/2026
NARRATIVE
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LPA observed required licensing forms and documents posted on a bulletin board near the entry door of the FCCH. LPA observed and tested a combination smoke and carbon monoxide detector at 12:43PM. Detector was found to be operational. The FCCH has a regulation fire extinguisher (2A10BC) that was purchased on 9/03/2025. LPA reminded the Licensee to either service or purchase a regulation fire extinguisher annually.

The backyard is enclosed with brick fencing, and the entry/exit points are secured. The backyard contains age-appropriate toys and play equipment. LPA reminded Licensee to replace toys and play equipment when such items begin to degrade or are not in good repair. LPA observed at the south end of the backyard barricaded is off limits and are where family tools and trash bins are stored, and children do not have access. Additionally, the LPA observed a large lemon tree that is fenced off to prevent access to children. LPA notes there are no bodies of water on site.

The children’s records were reviewed. The records are current and complete with emergency contact information, immunization records, and other required licensing forms and documents. The Licensee’s records were reviewed and found to be current with CPR/First Aid certifications (expire 5/18/2026) and Mandated Reporter training (5/23/2026). LPA note the most recent fire/emergency drill was conducted on 1/29/2026. LPA note there is a dog at the FCCH. LPA noted the dog’s vaccination records are with the licensee’s daughter and note the dog does interact with the children in care. Licensee states there are no firearms or ammunition stored on site.

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/.

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-andresources/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

Continue on LIC809C

NAME OF LICENSING PROGRAM MANAGER: Maria Mueller
NAME OF LICENSING PROGRAM ANALYST: Joaquin Mendez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2026
LIC809 (FAS) - (06/04)
Page: 4 of 5
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: GIJON FAMILY CHILD CARE
FACILITY NUMBER: 426217151
VISIT DATE: 01/29/2026
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recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Licensee was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.87, 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.

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.

The licensee provided proof of control of property. Because the licensee rents/leases the home, proof of landlord notification is required. (Use what applies to FCCH) The LPA observed the Property Owner/Landlord Notification form (LIC9151) that the LICENSEE confirms was provided to the property owner/landlord. The LICENSEE obtained a signed Property Owner/Landlord Consent form (LIC 9149). 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.

In today’s inspection (2) two Type B Deficiencies are being cited based on LPA observation, interview, and record reviews pursuant to Title 22 of the CA Code of Regulations (refer to LIC 809-D). Licensee was provided with a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee, Heliodora Gijon Carmona in her preferred language, Spanish.

NAME OF LICENSING PROGRAM MANAGER: Maria Mueller
NAME OF LICENSING PROGRAM ANALYST: Joaquin Mendez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2026
LIC809 (FAS) - (06/04)
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