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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426218064
Report Date: 07/31/2026
Date Signed: 07/31/2026 10:30:41 AM

Document Has Been Signed on 07/31/2026 10:30 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:CRUZ FAMILY CHILD CAREFACILITY NUMBER:
426218064
ADMINISTRATOR/
DIRECTOR:		TERESA CRUZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 406-9177
CITY:SANTA MARIASTATE: CAZIP CODE:
93454
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
07/31/2026
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:10 AM
MET WITH:Teresa CruzTIME VISIT/
INSPECTION COMPLETED:
10:45 AM
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This is a change of location, previous license number was 426216610.

On 07/31/26 at 9:10 AM, Licensing Program Analyst (LPA) Elizabeth George conducted an announced change of location, pre-licensing inspection as well as a change of capacity to a Large Family Child Care Home (FCCH) license. LPA met with licensee, Teresa Cruz, and discussed the purpose of today’s inspection. LPA in the company of the licensee toured the interior and exterior of the home in its entirety. Licensee will operate Monday thru Saturday, from 5 AM – 12 AM and serve children 0 – 12 years of age.

Licensee requested a change of location and a change of capacity to a large family child care home license. The home is a single story residence and includes three bedrooms, two bathrooms, living room, dining room, kitchen, sun room and an enclosed backyard. The areas licensed for care will be the living room, dining room, sun room and one bathroom for child care. The remainder of the home will be completely off limits to children in care. LPA observed all off limit areas to be inaccessible to children in care by means of door knob covers and safety gates. The home was inspected for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children.

LPA observed the home to be clean and orderly with sufficient space and ventilation for children in care. LPA observed a screened fireplace in the living room inaccessible to children. LPA observed age-appropriate toys and equipment. Cleaning compounds and disinfectants are stored within a locked cabinet and in the off limit areas of the kitchen, inaccessible. Kitchen knives and sharps are stored out of reach of children. The bathroom to be used for children in care was observed to be clean, sanitary, and free of toxins/hazardous items accessible to children. Licensee was reminded to ensure all personal care items, especially those that

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Ana Tolentino
Elizabeth George
DATE: 07/31/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/31/2026
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: CRUZ FAMILY CHILD CARE
FACILITY NUMBER: 426218064
VISIT DATE: 07/31/2026
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indicate “keep out of reach of children’ are kept inaccessible to children in care. LPA did not observe any toxins/hazardous items accessible to children in the facility today.

The backyard is fully enclosed by wooden fencing and a brick wall. The fences entry/exit gates are secured. LPA observed concrete, turf and dirt as flooring in the backyard play area. Age-appropriate toys were observed in the backyard. Licensee has one dog which is secured in a separate area of the backyard behind a locked gate and licensee states that the vaccines are up to date. LPA advised to keep the vaccine records on hand as a precaution. The second area of the backyard is licensee’s personal backyard space which will be kept locked and inaccessible to children in care.

A regulation 2A10BC fire extinguisher was observed with a service date of 4/13/26. Licensee is reminded to service or purchase the fire extinguisher yearly. LPA had licensee test the dual smoke and carbon monoxide detector which was found operational at 9:26 AM. All adults in the home are fingerprint cleared. No bodies of water were observed on site. Licensee stated that there are no firearms or ammunition in the home.

Licensee’s Pediatric First Aid/CPR certification is valid until June 2028 and Mandated Reporter Certification is valid until January 2027. Preventative Health and Safety and Nutrition Training was completed on 8/11/22. Childcare orientation was completed on 7/27/22. LPA reminded Licensee of obligation to maintain current training and certifications.



The licensee provided proof of control of property via Grant Deed Title.

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 1596.871, 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 licensee 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

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NAME OF LICENSING PROGRAM MANAGER: Ana Tolentino
NAME OF LICENSING PROGRAM ANALYST: Elizabeth George
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/31/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2026
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: CRUZ FAMILY CHILD CARE
FACILITY NUMBER: 426218064
VISIT DATE: 07/31/2026
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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 recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

On this date, 07/31/26, 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 address. 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.

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.


The Santa Maria Fire Department granted a fire clearance following an inspection completed on 07/23/26.

Once licensed, the licensee is required to comply with the terms and limitations stated on the license.

The following was discussed with the licensee:

- In the absence of the licensee a qualified adult must be present supervising the children; a qualified adult is an individual who has a valid and current pediatric CPR & First Aid certification, TB clearance, immunization's, and a valid criminal record clearance associated to the facility license.

- A current roster of children enrolled must be available and maintained for a period of three years, even after children no longer are attending the facility.

- Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your home.

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NAME OF LICENSING PROGRAM MANAGER: Ana Tolentino
NAME OF LICENSING PROGRAM ANALYST: Elizabeth George
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/31/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2026
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: CRUZ FAMILY CHILD CARE
FACILITY NUMBER: 426218064
VISIT DATE: 07/31/2026
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- Reporting Requirements: Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing.

- Smoking is prohibited in a family child care home, 24/7.

- Children and Staff records must be maintained and updated as needed and must be available for review by the Department.

- No baby bouncers, No infant walkers, No Johnny jumpers, No saucer chairs permitted in the facility.

The home meets Title 22 of CCR requirements for a Large Family Child Care License and is effective today, 07/31/26.



A notice of site visit was given to licensee and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

Exit interview conducted and report was reviewed with licensee, Teresa Cruz.

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.
NAME OF LICENSING PROGRAM MANAGER: Ana Tolentino
NAME OF LICENSING PROGRAM ANALYST: Elizabeth George
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/31/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2026
LIC809 (FAS) - (06/04)
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