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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566215766
Report Date: 08/09/2023
Date Signed: 08/09/2023 05:20:58 PM

Document Has Been Signed on 08/09/2023 05:20 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:SANCHEZ FAMILY CHILD CAREFACILITY NUMBER:
566215766
ADMINISTRATOR:ARACELY MELISSA SANCHEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 248-4844
CITY:VENTURASTATE: CAZIP CODE:
93003
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
08/09/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
04:00 PM
MET WITH:Aracely SanchezTIME COMPLETED:
05:30 PM
NARRATIVE
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On August 9, 2023 at 04:00 AM Licensing Program Analyst (LPA) Laura Villanueva made an unannounced inspection to initiate a complaint investigation. LPA met with licensee, Aracely Sanchez and explained the purpose of the visit. LPA observed a total of 4 children under the care and supervision of licensee. While conducting a tour of the facility, LPA observed an infant swaddled in a rocking seat. LPA informed that an infant shall not be swaddled while in care. Licensee explained that infant was in care for a short time while his mother went to run an errand. Infant's siblings were also present. The infant's siblings (2) were present and they are enrolled. The infant is 5 weeks old and is not enrolled nor attending child care at the present time. Licensee has child records for the older children, but not for the infant. LPA advised licensee that any child present under her care shall have a child record on file.

Today, deficiencies cited under Title 22 Division 12.

Upon receipt of this report, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parent/guardians of children newly enrolled at the facility during the next 12 months. Licensee to provide LIC 9224 for each child in care and have each parent sign the form that they have received a copy of the report LIC 809 and LIC 809 D.

THIS REPORT MUST BE FILED IN FACILITY FILE AND MADE AVAILABLE FOR PUBLIC REVIEW FOR 3 YEARS.

A Notice of Site Visit (LIC 9213) along with Appeal Rights (LIC 9058) are provided to licensee at the conclusion. LPA notes, licensee was informed to ensure Notice of Site Visit is posted for 30 days or a civil penalty of $100 may apply.

SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Laura Villanueva
LICENSING EVALUATOR SIGNATURE: DATE: 08/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/09/2023
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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Document Has Been Signed on 08/09/2023 05:20 PM - It Cannot Be Edited


Created By: Laura Villanueva On 08/09/2023 at 04:03 PM
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: SANCHEZ FAMILY CHILD CARE
FACILITY NUMBER: 566215766

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/09/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/09/2023
Section Cited
HSC
102425(f)

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(102425 Infant Safe Sleep (f) An infant shall not be swaddled while in care.
This requirement was not met as evidenced by: An infant was in a rocking seat swaddled in a receiving blanket (picture taken). This poses an immediate threat to the health and safety of children in care. .
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LPA adviced licensee infants shall not be swaddles while in care at amy time. Licensee will write a statement detailing a plan of correct for the future.

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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.
SUPERVISOR'S NAME:George Mingle
LICENSING EVALUATOR NAME:Laura Villanueva
LICENSING EVALUATOR SIGNATURE:
DATE: 08/09/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/09/2023


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 08/09/2023 05:20 PM - It Cannot Be Edited


Created By: Laura Villanueva On 08/09/2023 at 04:16 PM
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: SANCHEZ FAMILY CHILD CARE
FACILITY NUMBER: 566215766

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/09/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/09/2023
Section Cited
HSC
102421(b)

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102421 Child's Records (b) The licensee shall maintain, in each child's record, a copy of the emergency information card as required in Section 102417(g)(7). This requirement was not met as evidenced by: An infant was present with no child file
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Licensee shall have parent of infant complete required documents before child may attend child care.
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present with no file present. This poses a potential risk to the health and safety of children in care.
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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.
SUPERVISOR'S NAME:George Mingle
LICENSING EVALUATOR NAME:Laura Villanueva
LICENSING EVALUATOR SIGNATURE:
DATE: 08/09/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/09/2023


LIC809 (FAS) - (06/04)
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