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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566217011
Report Date: 10/02/2024
Date Signed: 10/02/2024 12:06:59 PM

Document Has Been Signed on 10/02/2024 12:06 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:VALENCIA FAMILY CHILD CAREFACILITY NUMBER:
566217011
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 4DATE:
10/02/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:45 PM
MET WITH:Maria ValenciaTIME VISIT/
INSPECTION COMPLETED:
02:00 PM
NARRATIVE
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On October 2, 2024 at 12:46 PM Licensing Program Analyst (LPA) Aaliyah Zendejas conducted a Case Management - Deficiencies inspection due to the fact that during a visit, LPA noticed an adult in the facility taking care of children who was not associated to the facility. LPA with the licensee took a tour of the interior and exterior of the facility. At the time of the inspection there were 4 children under the care and supervision of 2 adults.

At the time of the inspection, LPA observed 1 cleared adult (A1) caring for children. Licensee informed LPA that they had gotten their fingerprint clearance already and was currently applying for a license. LPA checked associations to the current licensed FCCH and found that A1 was not associated, but did have a valid fingerprint clearance for their current pending application.

Licensee was reminded that all adults 18 and over, 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 Child Care Center. 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.

One type B deficiency was cited today. See attached 809-D.

Exit interview conducted and report was reviewed with the facility representative.
Appeal rights were provided.
SUPERVISORS NAME: Lissete Gonzalez
LICENSING EVALUATOR NAME: Aaliyah Zendejas
LICENSING EVALUATOR SIGNATURE: DATE: 10/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/02/2024
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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Document Has Been Signed on 10/02/2024 12:06 PM - It Cannot Be Edited


Created By: Aaliyah Zendejas On 10/02/2024 at 11:50 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: VALENCIA FAMILY CHILD CARE
FACILITY NUMBER: 566217011

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/02/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/16/2024
Section Cited
CCR
102370(a)

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102370 Criminal Record Clearance (a) Prior to the Department issuing a license, the applicant(s) and all adults residing in the home shall obtain a California criminal record clearance or exemption.
This requirement was not met as evidence by:
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Licensee is to associate adult to the facilty by POC due date.
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Based on observation, interview, and record review, the licensee did not comply with the section cited above where 1 assistant was working in the FCCH with children but was not associated to the facility which poses a potential health, safety or personal rights risk to persons 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:Lissete Gonzalez
LICENSING EVALUATOR NAME:Aaliyah Zendejas
LICENSING EVALUATOR SIGNATURE:
DATE: 10/02/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/02/2024


LIC809 (FAS) - (06/04)
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