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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566215676
Report Date: 11/26/2025
Date Signed: 11/26/2025 10:43:16 AM

Document Has Been Signed on 11/26/2025 10:43 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:ORTIZ FAMILY CHILD CAREFACILITY NUMBER:
566215676
ADMINISTRATOR/
DIRECTOR:		JUANA ORTIZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 794-5609
CITY:VENTURASTATE: CAZIP CODE:
93004
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 1DATE:
11/26/2025
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:48 AM
MET WITH:Juana Ortiz TIME VISIT/
INSPECTION COMPLETED:
11:03 AM
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On November 26, 2025 , at 8:48 AM Licensing Program Analyst (LPA) Cynthia Alvarez conducted an unannounced 3 year required annual inspection. LPA met with licensee Juana Ortiz and discussed the nature and purpose of the inspection. Together both Licensee and LPA conducted a tour of the home inside and outside. There was 1 child in care at the time of the inspection, also present was 1 cleared and associated adult.

The Family Child Care Home (FCCH) is described as a 4-bedroom & 2-bathroom single-story home. The licensee utilizes family room, living room, kitchen, and 1 restroom for childcare. LPA observed that the Licensee stores their personal medication and knives in the kitchen in high elevated cabinets not accessible to children, the cleaning agents are stored underneath the sink, in a cabinet that is kept locked. The FCCH was observed to be clean and orderly. The FCCH has ventilation to afford for the children’s comfort. There are age-appropriate toys and furniture readily accessible to children. The bathroom used for children-in-care was observed to be clean and sanitary. Licensee stated they have a firearm in the home. LPA observed where firearms are stored, and it is inaccessible to the children in care in a safe, Licensee is following state regulations for firearm storage.

Licensee stated they do not use the backyard for childcare and instead walk over to the local park across the street. LPA indicated that information was noted on the last department visit; however, no updated facility sketch was submitted. Licensee agreed to allow LPA to review the backyard and stated they will be updating the facility sketch to reflect the backyard is off limits. LPA observed a hot tub in the backyard during the inspection; the hot tub is covered with a hard-shell cover with a strap lock on each corner of the hot tub.

Continued on 809-C

NAME OF LICENSING PROGRAM MANAGER: Susana Martinez
NAME OF LICENSING PROGRAM ANALYST: Cynthia Alvarez
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 11/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/26/2025
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.

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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: ORTIZ FAMILY CHILD CARE
FACILITY NUMBER: 566215676
VISIT DATE: 11/26/2025
NARRATIVE
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Required licensing forms are predominantly posted at the entrance of the family room. LPA observed a smoke and carbon monoxide detector in the FCCH. The detectors were tested at 9:13 AM and were found to be operable, and the Licensee is reminded to check the detectors to ensure they have operational batteries . The FCCH has a regulation fire extinguisher on site which was serviced on 03/2/2023. LPA reminded the Licensee that fire extinguishers must be serviced or purchased every year. Licensee stated they thought it was every 2 years. Licensee stated they will purchase a new one as soon as possible.

LPA reviewed children's records. The records are current, complete, and possessed emergency contact information. LPA requested to review the fire drill log; however, Licensee stated they do not log them drill but do conduct them every 3 months. LPA reminded Licensee that they must note when the drills are conducted. The Licensee's records were reviewed. Licensee’s pediatric CPR and First Aid certification expires on 9/22/2027. Licensee’s Mandated Reporter training expired on 6/2/2025, LPA reminded Licensee they must complete the training every 2 years.

Licensee was reminded that all adults 18 and over living or working in the home, 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)/ (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-and-resources/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 recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Continued on 809-C

NAME OF LICENSING PROGRAM MANAGER: Susana Martinez
NAME OF LICENSING PROGRAM ANALYST: Cynthia Alvarez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/26/2025
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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: ORTIZ FAMILY CHILD CARE
FACILITY NUMBER: 566215676
VISIT DATE: 11/26/2025
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Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare 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 LPAs completed the RSO profile in FAS.

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

A notice of site visit was given and must remain posted for 30 days.

During today's inspection 1 Type B citation was given and 2 Technical Violations were provide. Appeal Rights was provided to Licensee.

Exit interview conducted and report was translated in Spanish by LPA, for Juana Ortiz.

NAME OF LICENSING PROGRAM MANAGER: Susana Martinez
NAME OF LICENSING PROGRAM ANALYST: Cynthia Alvarez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/26/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 11/26/2025 10:43 AM - It Cannot Be Edited


Created By: Cynthia Alvarez On 11/26/2025 at 10:24 AM
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: ORTIZ FAMILY CHILD CARE
FACILITY NUMBER: 566215676

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/26/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above as they have expired Mandated Reporter training which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/05/2025
Plan of Correction
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Licensee will complete the Mandated Reporter Training by the date noted above. Licensee will send a copy of the certificate to LPA cynthia.alvarez@dss.ca.gov or 805-689-4212
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Susana Martinez
NAME OF LICENSING PROGRAM MANAGER:
Cynthia Alvarez
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 11/26/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/26/2025


LIC809 (FAS) - (06/04)
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