426217828-3-9-2026-17-CC-GNEE-DRZNWF-20260309104929

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 426217828
Report Date: 03/09/2026
Date Signed: 03/09/2026 10:49:49 AM

Document Has Been Signed on 03/09/2026 10:49 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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME:	SILVA DE MENDOZA FAMILY CHILD CARE		FACILITY NUMBER:	426217828
ADMINISTRATOR/ DIRECTOR:	ANDREA SILVA DE MENDOZA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 930-4598
CITY:	SANTA MARIA	STATE: CA	ZIP CODE:	93454
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 0	DATE:	03/09/2026
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:14 AM
MET WITH:	Andrea Silva De Mendoza		TIME VISIT/ INSPECTION COMPLETED:	10:35 AM

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This is a change of location inspection, previous license number is 426216856

On 3/9/26, Licensing Program Analyst (LPA) German Negrete conducted an announced Pre-Licensing/change of location inspection for a Large Family Child Care Home(FCCH) License and met with applicant Andrea Silva De Mendoza. The purpose of the inspection was discussed, and LPA and the applicant toured the interior and exterior of the home. At the time of the inspection, there were zero child(ren) present in the home. All adults residing in the home have an active criminal background clearance.

The applicant received a fire clearance from the fire inspector on 2/23/2026. The home is a single-story residence consisting of two bedrooms, one master bedroom/bathroom, hallway bathroom, living room, kitchen, family room, garage, and outdoor play area. The areas designated for child care use are living room, hallway bathroom and outdoor play area that is fenced off. The following areas have been made inaccessible to children in care through the use of door locks and/or child safety gates: kitchen, family room, two bedrooms, master bedroom/bathroom and garage.

LPA observed that hazardous items, including knives/cleaning supplies were stored in elevated cabinets(at least 5 feet high), making them inaccessible to children in care. There are no bodies of water on the property. Continued on LIC809-C(pg2)

NAME OF LICENSING PROGRAM MANAGER: Ana Tolentino
NAME OF LICENSING PROGRAM ANALYST: German Negrete
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 03/09/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2026

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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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: SILVA DE MENDOZA FAMILY CHILD CARE	FACILITY NUMBER: 426217828
	VISIT DATE: 03/09/2026

NARRATIVE

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The applicant stated there are no firearms or ammunition in the home. The home was observed to be clean, orderly, and well ventilated(via windows), and no hazards accessible to children in care were observed.

The bathroom designated for children in care was observed to be clean and free of toxins. Age-appropriate furniture, equipment, toys, and materials for child care activities were observed. LPA and the applicant toured the outdoor play area, which was observed to be fully fenced and includes shade/natural cover, via trees, for children in care.

No prohibited equipment will be allowed or used in the home, including but not limited to baby bouncers, infant walkers, Johnny jumpers, saucer chairs, trampolines, or similar equipment.

LPA observed the applicant test the dual smoke/carbon monoxide detector at 9:21am, and all were functioning properly at the time of the inspection. LPA observed a 2A10BC fire extinguisher, purchased on 2/22/2026, and reminded the applicant that the fire extinguisher must be serviced or replaced annually.

The applicant is current with immunization requirements pursuant to SB 792. The applicant completed the required orientation on 1/8/24. Pediatric First Aid/CPR certification is valid until 1/19/2027, and Mandated Reporter Training certification is valid until 2/11/2028. Applicant completed Health and Safety Training on 11/1/2022.

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

Continued on LIC809-C(pg3)

NAME OF LICENSING PROGRAM MANAGER: Ana Tolentino
NAME OF LICENSING PROGRAM ANALYST: German Negrete
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 03/09/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2026

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: SILVA DE MENDOZA FAMILY CHILD CARE	FACILITY NUMBER: 426217828
	VISIT DATE: 03/09/2026

NARRATIVE

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LPA discussed the safe sleep regulations with applicant, and discussed the Child Care Licensing Safe Sleep webpage at 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, 3/9/26, 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.

Applicant 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.

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. Continued on LIC809-C(pg4)

NAME OF LICENSING PROGRAM MANAGER: Ana Tolentino
NAME OF LICENSING PROGRAM ANALYST: German Negrete
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 03/09/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2026

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: SILVA DE MENDOZA FAMILY CHILD CARE	FACILITY NUMBER: 426217828
	VISIT DATE: 03/09/2026

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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

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.

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.

An exit interview was conducted, and the report was reviewed with applicant Andrea Silvia De Mendoza . The home meets Title 22 California Code of Regulations for a Large Family Child Care Home. Licensure will be pending managers review.

THE NOTICE OF SITE VISIT WAS POSTED AS REQUIRED BY H&S CODE SEC. 1596.817. THE NOTICE OF SITE VISIT MUST REMAIN POSTED FOR 30 DAYS OR A CIVIL PENALTY OF $100.00 WILL APPLY.

NAME OF LICENSING PROGRAM MANAGER: Ana Tolentino
NAME OF LICENSING PROGRAM ANALYST: German Negrete
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 03/09/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2026

LIC809 (FAS) - (06/04)

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