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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426217210
Report Date: 12/09/2024
Date Signed: 12/09/2024 03:49:41 PM

Document Has Been Signed on 12/09/2024 03:49 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:CARDENAS FAMILY CHILD CAREFACILITY NUMBER:
426217210
ADMINISTRATOR/
DIRECTOR:
FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 3DATE:
12/09/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:20 PM
MET WITH: Esmeralda Cardenas TIME VISIT/
INSPECTION COMPLETED:
04:00 PM
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On 12/9/24, at 2:20 PM, Licensing Program Analysts (LPAs) Joaquin Mendez and Elvin Baddley conducted an announced Prelicense Inspection of the abovementioned home. It should be noted an initial Prelicense Inspection of the home was conducted on 11/19/24. Additionally, LPAs meet with Applicant Esmeralda Cardenas on 12/4/24, to discuss the corrections needed for licensure. Today's inspections will serve as a continuance of the Prelicense Inspection and assess the corrections for licensure.

LPAs met with Applicant and explained the purpose and nature of the inspection. It should be noted LPAs observed three children (biological) on site during the time of the inspection.

LPAs toured the interior and exterior of the home, in the company of Applicant. Applicant discussed the locations child care services with LPAs, both inside and outside of the home. LPAs note the home is a three bedroom, three bedroom single story dwelling. The home's living room, dining room, kitchen, converted office, garage, bathrooms (two) and eastern side yard will be used for child care services, while the home's bedrooms and western side yard, shed and front driveway area will be excluded from care.

The home has ample ventilation and space for children in care. Additionally, the home has safety mechanisms in place to ensure children will not have access to hazardous or toxic items. The Applicant has been reminded the garage will serve as a supplemental area for child care, but can not be used for napping/sleeping children without proper building permits.

Exit interview conducted and report was reviewed with the Applicant Esmeralda Cardenas. The inspection was conducted in Spanish and report was translated in Spanish by LPA Mendez.

The home meets Title 22 Division 12 requirements of a FCCH Small License. Effective date of license will be noted as the present, 12/9/24.

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE: DATE: 12/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/09/2024
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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