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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426217439
Report Date: 04/24/2025
Date Signed: 04/24/2025 12:08:10 PM

Document Has Been Signed on 04/24/2025 12:08 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:VELASQUEZ FAMILY CHILD CAREFACILITY NUMBER:
426217439
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
04/24/2025
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Maria Del Carmen Castillo VelasquezTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
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This is a change of location, previous license number was 426216438.

On April 24, 2025 at 9:30 AM, Licensing Program Analyst (LPA) Bill Billones conducted an announced change of location, Pre-licensing inspection for a Small Family Child Care Home (FCCH) license. LPA met with Maria Del Carmen Castillo Velasquez, applicant of the FCCH and discussed the purpose of today’s inspection. LPA and Applicant toured the inside and outside of the home. The applicant’s 4 children were at the home at the time of the inspection and no other adults present. The hours of operation will be 7:30 AM to 5:30 PM , Monday through Friday.

Applicant requested a change of location for a small family childcare license. The home is a one-story home with three (3) bedrooms, three (3) bathrooms, living room, kitchen, dining area, playroom, garage, and outdoor yard. LPA notes that the day care services will occur in the living room, dining area, kitchen, one (1) bathroom, one (1) playroom, and outdoor patio. The living room has an open face heater that is screened. Meanwhile, the three (3) bedrooms, two (2) bathrooms, and garage will be off-limits to children in care. The hallway to two (2) bedrooms and one (1) bathroom is through locked door, making those areas inaccessible to children in care. LPA observed an open face heater in an inaccessible hallway. LPA observed a fireplace, which applicant states is non-working and an open face heater in one (1) bedroom next to playroom, which is unlocked and off-limits to day care. Licensee put screens on fireplace and the open face heater during inspection to make them inaccessible to children in care. The backyard is enclosed by cinder block fencing. LPA observed three (3) wooden latched gates kept secured. No bodies of water were observed. Licensee states no firearms or ammunition are stored on premises.

CONTINUED ON 809-C

NAME OF LICENSING PROGRAM MANAGER: Ana Tolentino
NAME OF LICENSING PROGRAM ANALYST: Bill-Brian Billones
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/24/2025
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: VELASQUEZ FAMILY CHILD CARE
FACILITY NUMBER: 426217439
VISIT DATE: 04/24/2025
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LPA observed the FCCH is fully equipped to meet the needs of children in care. In addition, there is plenty of ventilation in the home. LPA did not observe any toxins nor hazardous items accessible to children in care. LPA observed that knives and medications are stored in a kitchen cabinet inaccessible to children.

The carbon monoxide detector and the smoke alarm located in the kitchen area were tested at 10:14 AM and were found to be in working condition. LPA observed a regulatory fire extinguisher with purchase date of 4/21/2025 in the home. Children have access to toys that are age-appropriate inside and outside of the home.

The licensee provided proof of control of property.

Applicant 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 1596.871, 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.

LPA discussed the safe sleep regulations with applicant 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 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, 4/24/2025, 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 disclosure; 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.

CONTINUED ON 809-C

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

DATE: 04/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2025
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: VELASQUEZ FAMILY CHILD CARE
FACILITY NUMBER: 426217439
VISIT DATE: 04/24/2025
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Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms.

LPA reviewed with applicant the LIC 311D, Forms/Records to Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the applicant.

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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

Applicant's Pediatric First Aid/CPR certificate is valid through 10/9/2026. Licensee was reminded to renew their certification every two years. Licensee was reminded a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter certification AB1207 every two years at www.mandatedreporterca.com. Applicant's mandated reporter certificate is valid through 3/25/2027.

To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

LPA provided the following resources to the applicant:


- Entrance checklist for a Family Child Care Home (FCCH)- LIC126.
- Pictorial handout of items not permitted in a home.
- Pictorial poster of poisonous plants.

The home meets Title 22 Division 12 requirements of a Small FCCH. Effective date of license is today, April 24, 2025. Once licensed, the applicant is required to comply with the terms and limitations stated on the license.

CONTINUED ON 809-C

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

DATE: 04/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2025
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: VELASQUEZ FAMILY CHILD CARE
FACILITY NUMBER: 426217439
VISIT DATE: 04/24/2025
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A notice of site visit was given to applicant and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

Exit interview conducted, appeal rights were provided, and report was reviewed with the applicant Maria Del Carmen Castillo Velasquez.

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

DATE: 04/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2025
LIC809 (FAS) - (06/04)
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