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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566216974
Report Date: 10/24/2024
Date Signed: 10/24/2024 02:16:55 PM

Document Has Been Signed on 10/24/2024 02:16 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:HERNANDEZ GARCIA FAMILY CHILD CAREFACILITY NUMBER:
566216974
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 2DATE:
10/24/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:30 PM
MET WITH:Gloria Hernandez GarciaTIME VISIT/
INSPECTION COMPLETED:
02:31 PM
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On October 24, 2024 Licensing Program Analyst (LPA) Susana Martinez conducted an unannounced Case Management- Licensee Initiated inspection for the purpose of increasing the capacity. LPA met with Licensee Gloria Hernandez Garcia and advised her of the purpose for the inspection. Together with the Licensee, LPA toured the facility inside and outside. At the time of inspection there was 2 child in the care of Licensee, no other adults were present in the home. Licensee denies having guns/ammunition in the home.

This is a single-story home which consists of three bedrooms, one restroom, living room, kitchen, fenced backyard, and an additional detached room. Licensee uses one bathroom, living-room, kitchen, dining room, and enclosed backyard for day-care use. No bodies of water were observed at the time of inspection.

A Fire Clearance has been granted by the Oxnard Fire Department on 10/15/24.

Because the licensee rents/leases the home, proof of landlord notification is required. The LPA observed the Property Owner/Landlord Notification form (LIC9151) that the Licensee confirms was provided to the property owner/landlord. The applicant obtained a signed Property Owner/Landlord Consent form (LIC 9149).
The home meets Title 22 Regulations for a Large Family Child Care Home (FCCH). Large License is effective today 10/24/2024.

LPA advised Licensee that once licensed for a Large FCCH, the capacity limitations shall be maintained at all times. When there is no Qualified Assistant, the capacity must revert back to the requirements of a Small FCCH. Licensee must notify the parents when caring for more than 12 children using the form LIC9150.
LPA provided a Spanish pictorial handout of the capacity requirements for a large FCCH.

No deficiencies were issued during today's inspection. Notice of site visit was given and should remain posted for a minimum of 30 days.

Exit interview conducted appeal rights were given and report was reviewed in Spanish with Licensee, Gloria Hernandez Garcia.
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Susana Martinez
LICENSING EVALUATOR SIGNATURE: DATE: 10/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/24/2024
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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