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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566215781
Report Date: 11/06/2025
Date Signed: 11/06/2025 03:52:21 PM

Document Has Been Signed on 11/06/2025 03:52 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:MELENDEZ-SANTOS FAMILY CHILD CAREFACILITY NUMBER:
566215781
ADMINISTRATOR/
DIRECTOR:		CATRINA MELENDEZ-SANTOSFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 710-7385
CITY:SIMI VALLEYSTATE: CAZIP CODE:
93065
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 10DATE:
11/06/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:07 AM
MET WITH:Catrina Melendez-SantosTIME VISIT/
INSPECTION COMPLETED:
04:05 PM
NARRATIVE
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On 11/06/2025, at 10:07 AM PST, Licensing Program Analyst (LPA) Seena Parsapour conducted an unannounced Annual/Random inspection of the above-mentioned Family Child Care Home (FCCH). LPA met with licensee Catrina Melendez-Santos. LPA explained to licensee the purpose of the inspection and, in the company of the Licensee, toured the interior and exterior of the FCCH in its entirety. The home consists of three (3) bedrooms, two (2) bathrooms, living room, kitchen, dining area, and backyard. LPA notes that the day care services occur in the living room, dining area, one (1) bathroom, and backyard, with off-limits areas enforced by various means including childproof gates. At the beginning of the inspection, LPA observed, and was informed by Licensee, that there were ten (10) daycare children in care, and one (1) assistant present, who was the licensee’s husband. LPA also notes that the Licensee’s thirteen-year-old daughter was in the home at the time of the inspection.

At 10:12 AM PST, by interview and observation, LPA confirmed that, of the three (3) total infants and seven (7) total remaining children present at the time of the inspection, two (2) of the infants and one (1) three-year old child were sleeping in cribs located inside of a bedroom (daycare room), with the bedroom being separated by walls & out of sight from the living room area, where the remaining six (6) children were playing, while the assistant of the daycare (Licensee's husband) was in a separate (off-limits) bedroom inside the home, and while the Licensee stepped away to provide care to the children inside the daycare room. LPA informed licensee on requirements pertaining to safe sleep, as well as care & supervision, per regulations, and discussed plan of correction for deficiencies being issued.

The bathroom for the FCCH was observed to be clean and hazard-free. Toys, furniture and equipment observed in the FCCH were found to be age-appropriate. LPA observed required licensing forms and documents posted on a bulletin board near the entrance of the FCCH. (Cont. 809-C, Page 2)

NAME OF LICENSING PROGRAM MANAGER: Maria Mueller
NAME OF LICENSING PROGRAM ANALYST: Seena Parsapour
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 11/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/06/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 10
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)
Page: 2 of 10
Document Has Been Signed on 11/06/2025 03:52 PM - It Cannot Be Edited


Created By: Seena Parsapour On 11/06/2025 at 02:19 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: MELENDEZ-SANTOS FAMILY CHILD CARE
FACILITY NUMBER: 566215781

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/06/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102417(a)
Operation of A Family Child Care Home
(a) The licensee shall be present in the home and shall ensure that children in care are supervised at all times. When circumstances require the licensee to be temporarily absent from the home, the licensee shall arrange for a substitute adult to care for and supervise the children during his/her absence. Temporary absences shall not exceed 20 percent of the hours that the facility is providing care per day.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above in that two (2) infants and one (1) three-year old child were sleeping in cribs located inside of a bedroom (daycare room), separate & out of sight from the living room area, where the remaining six (6) children were playing, while the assistant of the daycare (Licensee's husband) was in a separate (off-limits) bedroom inside the home, and while the Licensee stepped away to provide care to the children inside the daycare room, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 11/07/2025
Plan of Correction
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Licensee will submit to the Department (seena.parsapour@dss.ca.gov) a written statement explaining how they plan on ensuring compliance with this regulation moving forward, no later than tomorrow, November 7th, 2025. Licensee understands that proper care & supervision must be provided to all children in care at all times, per regulations, and affirms this as part of the written statement. LPA observed correction on-site after informing Licensee & Assistant to provide care & supervision to all children in care at all times.
Type A
Section Cited
CCR
102425(j)(5)(A)
Infant Safe Sleep
The provider shall supervise infants while they are sleeping and adhere to the following requirements: If the infant is sleeping in a separate room from where the provider is stationed, the door to the room the infant is sleeping in shall remain open at all times. The provider shall be able to visually observe the infant without moving the door.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above in that two (2) infants and one (1) three-year old child were sleeping in cribs located inside of a bedroom (daycare room), separate & out of sight from the living room area, where the remaining six (6) children were playing, while the assistant of the daycare (Licensee's husband) was in a separate (off-limits) bedroom inside the home, and while the Licensee stepped away to provide care to the children inside the daycare room, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 11/07/2025
Plan of Correction
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Licensee will submit to the Department (seena.parsapour@dss.ca.gov) a written statement explaining how they plan on ensuring compliance with this regulation moving forward, no later than tomorrow, November 7th, 2025. Licensee understands that proper care & supervision must be provided to all children in care at all times, per regulations, and affirms this as part of the written statement. LPA observed correction on-site after informing Licensee & Assistant to provide care & supervision to all children in care at all times.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Maria Mueller
NAME OF LICENSING PROGRAM MANAGER:
Seena Parsapour
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 11/06/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/06/2025


LIC809 (FAS) - (06/04)
Page: 3 of 10
Document Has Been Signed on 11/06/2025 03:52 PM - It Cannot Be Edited


Created By: Seena Parsapour On 11/06/2025 at 02:19 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: MELENDEZ-SANTOS FAMILY CHILD CARE
FACILITY NUMBER: 566215781

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/06/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to:

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 in that both of the two (2) fire extinguishers present on the property at the time of the inspection, were last purchased on 5/14/2024, and had not been serviced since this date, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/14/2025
Plan of Correction
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Licensee will submit to the Department (seena.parsapour@dss.ca.gov) a written statement explaining how she plans on ensuring compliance with this regulation moving forward, no later than Friday, November 14th, 2025. LPA observed on-site correction of this deficiency, as the Assistant purchased & installed a regulation fire extinguisher (of type 3A40BC) on today's date, 11/06/2025, during the inspection. Licensee understands that a regulation fire extinguisher must either be purchased or serviced annually, since its original date of purchase.
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.
Maria Mueller
NAME OF LICENSING PROGRAM MANAGER:
Seena Parsapour
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 11/06/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/06/2025


LIC809 (FAS) - (06/04)
Page: 4 of 10
Document Has Been Signed on 11/06/2025 03:52 PM - It Cannot Be Edited


Created By: Seena Parsapour On 11/06/2025 at 02:19 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: MELENDEZ-SANTOS FAMILY CHILD CARE
FACILITY NUMBER: 566215781

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/06/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(9)(A)1
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (9) Each family child care home shall have a written disaster plan of action prepared on a form approved by the Department. All children, age and ability permitting, and the provider, the assistant provider, and other members of the household, shall be instructed in their duties under the disaster plan. As their age and ability permit, newly enrolled children shall be informed promptly of their duties as required in the plan. (A) Each family child care home shall conduct fire drills and disaster drills at least once every six months. 1. The licensee shall document the drills, including the date and time of each drill. This documentation shall kept at the family child care home.

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 in that a fire or disaster drill was not conducted and/or documented as having been completed within the last six (6) months as required, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/14/2025
Plan of Correction
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Licensee will submit to the Department (seena.parsapour@dss.ca.gov) a written statement explaining how she plans on ensuring compliance with this regulation moving forward, no later than Friday, November 14th, 2025. LPA notes that the Licensee conducted & documented a fire drill during today's inspection.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Maria Mueller
NAME OF LICENSING PROGRAM MANAGER:
Seena Parsapour
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 11/06/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/06/2025


LIC809 (FAS) - (06/04)
Page: 5 of 10
Document Has Been Signed on 11/06/2025 03:52 PM - It Cannot Be Edited


Created By: Seena Parsapour On 11/06/2025 at 02:19 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: MELENDEZ-SANTOS FAMILY CHILD CARE
FACILITY NUMBER: 566215781

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/06/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(j)(1)
Infant Safe Sleep
The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall physically check on the infant every 15 minutes.

This requirement is not met as evidenced by:
Deficient Practice Statement
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3
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Based on interview and record review, the licensee did not comply with the section cited above in that 15-minute safe sleep checks were not conducted and/or documented for Child #01 (C1), who was asleep during the inspection, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/14/2025
Plan of Correction
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3
4
Licensee will submit a written statement to the Department (seena.parsapour@dss.ca.gov) explaining how they plan on ensuring compliance with this regulation moving forward, no later than Friday, November 14th, 2025.
Type B
Section Cited
CCR
102417(m)(3)
Operation of A Family Child Care Home
(3) A file of affidavits signed by each parent with a child enrolled in the home. The affidavit shall state that the parent has been informed that the family child care home does not carry liability insurance or a bond according to standards established by the state.

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 in that the LIC 282 - Affadavit Regarding Liability Insurance for Family Child Care Home, was not on file for any of the children in care at the time of the inspection (C1-C10), which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/14/2025
Plan of Correction
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Licensee will submit a written statement to the Department (seena.parsapour@dss.ca.gov) explaining how they plan on ensuring compliance with this regulation moving forward, and will also submit to the Department proof of having obtained completed LIC 282 forms for all children currently enrolled, no later than Friday, November 14th, 2025.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Maria Mueller
NAME OF LICENSING PROGRAM MANAGER:
Seena Parsapour
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 11/06/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/06/2025


LIC809 (FAS) - (06/04)
Page: 6 of 10
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: MELENDEZ-SANTOS FAMILY CHILD CARE
FACILITY NUMBER: 566215781
VISIT DATE: 11/06/2025
NARRATIVE
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A dual smoke & carbon monoxide detector was present in the FCCH, and was tested at 10:29AM, and found to be operational. At 10:36AM PST, by observation and interview, LPA found that both of the two (2) fire extinguishers present on the property (both of type 3A40BC), were last purchased on 5/14/2024, and had not been serviced since this date. LPA notes that Licensee's husband purchased and installed a regulation fire extinguisher (of type 3A40BC) during the inspection, thereby correcting this deficiency on-site. LPA reminded the Licensee to either service or purchase a regulation fire extinguisher annually. The backyard/outdoor area is accessible for daycare purposes, is fully enclosed, and consists of various toys & play equipment. LPA reminded licensee of the types of equipment which are prohibited from use at FCCHs. LPA reminded licensee that care and supervision are required at all times when children are inside or outside of the FCCH. Age-appropriate toys & play equipment were observed in the backyard area. LPA reminded Licensee to replace toys and play equipment when such items begin to degrade or are not in good repair. LPA observed no bodies of water on site, and confirmed this was the case with Licensee. LPA notes that there are multiple locked sheds containing household items, and five (5) dogs kept in enclosed cages in the backyard, which have current vaccinations. Licensee advised LPA that children in care are not permitted to interact with the dogs. LPA notes that two active fish tanks are located inside of the living room area. LPA notes there is a school bus in the driveway of the FCCH, which Licensee advises is being converted into a motorhome. Licensee advises the school bus remains locked during daycare hours.

Children’s records were reviewed for all ten (10) children in care at the time of the inspection. At 12:33PM PST, by record review and interview, LPA discovered that Licensee has on file their own version of the LIC 627 – Consent for Emergency Medical Treatment form for all enrolled children, but that no mention of emergency dental care is made on the form. After LPA discussed with Licensee, Licensee agreed that they will begin using the Department's LIC 627 form for all children enrolled currently & in the future at the FCCH, to ensure compliance. At 12:49PM PST, by interview and record review, LPA confirmed that the LIC 282 - Affadavit Regarding Liability Insurance for Family Child Care Home, was not on file for any of the children in care at the time of the inspection. LPA also reviewed 15-minute safe sleep check logs for all three (3) infants present at the time of the inspection (C1, C8, & C10). At 11:16AM PST, by observation, record review, and interview, LPA confirmed that 15-minute safe sleep checks were not conducted and/or documented for Child #01 (C1), who LPA observed asleep in a crib located inside of the daycare room at the time of the inspection. (Cont. 809-C, Page 3).

NAME OF LICENSING PROGRAM MANAGER: Maria Mueller
NAME OF LICENSING PROGRAM ANALYST: Seena Parsapour
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2025
LIC809 (FAS) - (06/04)
Page: 8 of 10
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: MELENDEZ-SANTOS FAMILY CHILD CARE
FACILITY NUMBER: 566215781
VISIT DATE: 11/06/2025
NARRATIVE
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The children’s records were found to otherwise be current & complete. Licensee was reminded of their responsibility to ensure that a separate, complete, and current record is maintained for each child in care. The Licensee’s and Assistant’s records were reviewed, and were found to be current and complete. At 11:03 AM PST, by record review and interview, LPA confirmed that a fire or disaster drill was not conducted and/or documented as having been completed within the last six (6) months as required. LPA notes that a fire drill was completed & documented during the inspection. LPA reminded licensee of the requirement to conduct & document such drills every 6 months. Licensee states there are no firearms or ammunition stored on site.

LPA observed cleaning supplies, family medications, knives, and other hazardous items stored in areas inaccessible to children in care. Since drawers and cabinets in the kitchen were not latched or locked, LPA reminded licensee of the requirement to ensure that childproof gates remain closed during operating hours.

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/.

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.

Licensee was informed of the MyChildCarePlan.org website; 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. (Cont. 809-C, Page 4)

NAME OF LICENSING PROGRAM MANAGER: Maria Mueller
NAME OF LICENSING PROGRAM ANALYST: Seena Parsapour
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2025
LIC809 (FAS) - (06/04)
Page: 9 of 10
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: MELENDEZ-SANTOS FAMILY CHILD CARE
FACILITY NUMBER: 566215781
VISIT DATE: 11/06/2025
NARRATIVE
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During the exit interview the Licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS. 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.

During today's visit, two (2) Type A deficiencies and four (4) Type B deficiencies were cited under Title 22 of the California Code of Regulations and Health and Safety Codes (see LIC 809-D). One (1) Technical Violation (TV) was also issued.

Upon receipt, Licensee was informed that they must provide copies of this licensing report to each parent/guardian of enrolled children, and to parents/guardians of newly enrolled children during the next 12 months. Acknowledgement of Receipt LIC 9224 form shall be used for this purpose. LIC 9224, once completed, shall be maintained in each child's file. (LIC 9224 was provided to Licensee).

Appeal Rights were provided to Licensee. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Licensee, Catrina Melendez-Santos.

NAME OF LICENSING PROGRAM MANAGER: Maria Mueller
NAME OF LICENSING PROGRAM ANALYST: Seena Parsapour
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2025
LIC809 (FAS) - (06/04)
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