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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566216598
Report Date: 03/04/2025
Date Signed: 03/04/2025 12:14:42 PM

Document Has Been Signed on 03/04/2025 12:14 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:ISLAS FAMILY CHILD CAREFACILITY NUMBER:
566216598
ADMINISTRATOR/
DIRECTOR:		NATALIE ISLASFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 799-7876
CITY:OXNARDSTATE: CAZIP CODE:
93036
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 5DATE:
03/04/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:15 AM
MET WITH:Natalie Islas & Josefina GarciaTIME VISIT/
INSPECTION COMPLETED:
10:45 AM
NARRATIVE
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On 03/04/2025 at 10:15 AM, Licensing Program Analysts (LPAs) Fernando Hernandez and Laura Carone conducted an unannounced Case management/Incident Inspection. LPAs met with licensee Natalie Islas and advised the purpose of the inspection. Licensee provided LPAs a tour of the home inside and out. There were 5 children in care at the time of the inspection.

During todays inspection, LPAs observed C1 with a burn on his right hand. LPAs asked licensee what occurred, licensee stated grandma brought siblings and licensee asked where C1 was grandma informed Licensee that C1 will not be attending. Licensee asked siblings what occurred, siblings stated he had burnt his hand. That same afternoon the parent called the licensee asking if licensee could watch C1 and mentioned that C1 went to the hospital due to a burn on his hand. Licensee stated child was out for (2) days. LPAs asked licensee if she reported the incident to the Department, licensee informed LPAs she did not. LPAs informed Licensee that it her responsibility as a Mandated Reporter to report any suspicious injury to the Department and Child protective Services (CPS). LPAs gave licensee the LIC 624 Unusual Incident/injury report to complete during inspection.

A Type B citation was issued during todays inspection see LIC 809-D. Appeal rights were given.

Exit interview was conducted and report was reviewed with licensee Natalie Islas.

SUPERVISORS NAME: Susana Martinez
LICENSING EVALUATOR NAME: Fernando Hernandez
LICENSING EVALUATOR SIGNATURE: DATE: 03/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/04/2025
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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Document Has Been Signed on 03/04/2025 12:14 PM - It Cannot Be Edited


Created By: Fernando Hernandez On 03/04/2025 at 11:23 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: ISLAS FAMILY CHILD CARE
FACILITY NUMBER: 566216598

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/04/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/04/2025
Section Cited
CCR
102416.2(b)(1)

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102416.2 Reporting Requirements
(b) The licensee shall report to the Department... that occur during the operation of the family child care home. (1) Medical treatment...as defined in Section 101152(m).
This requirement was not met as evidence by:
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Licensee completed the LIC 624 Unusual Incident/injury report during inspection. LPA's took a copy of the report. Licensee will call/text LPA Hernandez onceLicensee has contacted CPS.
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LPAs observed C1 with burn marks on their right hand. LPAs asked licensee if they reported the incident to the Department and Child Protective Services. Licensee stated she did not. This poses a potential threat to the 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:Susana Martinez
LICENSING EVALUATOR NAME:Fernando Hernandez
LICENSING EVALUATOR SIGNATURE:
DATE: 03/04/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/04/2025


LIC809 (FAS) - (06/04)
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