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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406211893
Report Date: 06/06/2025
Date Signed: 06/06/2025 04:20:18 PM

Document Has Been Signed on 06/06/2025 04:20 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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:CANCHE FAMILY CHILD CAREFACILITY NUMBER:
406211893
ADMINISTRATOR/
DIRECTOR:
MARY CANCHEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 904-3030
CITY:NIPOMOSTATE: CAZIP CODE:
93444
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
06/06/2025
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:15 PM
MET WITH:Juan CancheTIME VISIT/
INSPECTION COMPLETED:
04:35 PM
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On 6/6/25, at 1:15 PM, Licensing Program Analyst (LPA) Matthew Sapien conducted a comprehensive annual required inspection of the abovementioned Family Child Care Home (FCCH). LPA met with Juan Canche, the Licensee's Husband of the FCCH, and explained the nature and purpose of the inspection. The LPA, in the company of Juan Canche, toured the interior and exterior of the FCCH. The house is a 5 bedroom and 2 bathroom two story home. The areas that are accessible for day care children are as follows: living room (main playroom), dining room, bathroom, and the backyard. The remainder of the home is excluded from childcare services, including the entirety of the second story. The second story of the home and other inaccessible areas and cabinets are made secure by child safety gates, knobs, and locks. At the time of the inspection, LPA only observed the Licensee's adult son present, Juan Canche Jr., who is cleared and associated. Importantly to note, during the initial inspection, the Licensee was not present due to taking children out on a field trip for the start of summer break. Around 3:45 PM, the Licensee eventually arrived at the FCCH along with 5 day care children. The other children were met with their parents and picked up.

The bathroom utilized for childcare is clean and free of toxins. LPA observed the bathroom cabinet to contain no potentially hazardous items. LPA observed sharps and personal medication in locked and elevated kitchen cabinets. No children currently require medication. Cleaning supplies are housed in the garage, an excluded area. LPA also observed a First Aid Kit in the residence for the day care.

LPA observed age-appropriate toys, furnishings, and equipment throughout the day care room.

LPA also observed relevant licensing forms and documents posted prominently in the FCCH. LPA observed separate smoke and carbon monoxide detectors within the FCCH. The smoke detector and carbon monoxide detectors were each tested at 2:00 PM were found to be operational. (CONT. 809-C, Page 2)

NAME OF LICENSING PROGRAM MANAGER: Maria Mueller
NAME OF LICENSING PROGRAM ANALYST: Matthew Sapien
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/06/2025
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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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)
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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: CANCHE FAMILY CHILD CARE
FACILITY NUMBER: 406211893
VISIT DATE: 06/06/2025
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LPA observed a regulation fire extinguisher in the FCCH which was last serviced on 10/23/24. LPA reminded the Facility Representative to either service or purchase a regulation fire extinguisher annually. LPA reviewed the FCCH's fire/disaster drill log. The most recent disaster drill occurred on 6/6/25. LPA informed the Facility Representative the responsibility to conduct disaster drills every six months as required by the Department.

As noted prior, the backyard is accessible to children in care. The FCCH's backyard is enclosed by wooden fencing and a large stucco wall throughout. The fence’s entry/exit points are secure. As is the case with the interior of the FCCH, the outdoor area has age-appropriate play structures, toys, and other equipment throughout the area that can afford for healthful childcare services. Facility Representative was reminded to replace toys and play equipment which start to degrade or are not in good repair. The footing of the exterior is made up of varying surfaces (concrete pavement, artificial turf, dirt, and rocks). LPA observed a locked shed in the backyard that contains construction and party supplies per the Facility Representative. LPA also observed a few refrigerators, some of which are non-operational, while others are and possess food items for children and the Facility Representative's family. The Facility Representative attested to LPA that children are always supervised when engaged in outside activity. LPA confirmed that the Facility Representative does not have any bodies of water on site. LPA notes four smaller dogs present at the FCCH. Facility Representative informed LPA that out of the four dogs, only one dog has interactions with children. This one dog is utilized as an emotional service animal for children. Facility Representative informed LPA that the each dog is current with their vaccinations.

LPA reviewed children's records. The records are current, complete, and possessed emergency contact information and immunization records, among other relevant licensing documents and forms. The Licensee's records were also reviewed. LPA found that the Licensee completed their First Aid/CPR Training (EMSA approved) on 12/31/24 and their Mandated Reporter Training on 8/8/24. Licensee was reminded to renew certifications and training prior to expirations. The Facility Representative informed LPA that there are no firearms or ammunition that are stored on site.

The Facility Representative does not currently provide Incidental Medical Services (IMS) or administer medication to children in care. IMS policy was discussed. For IMS information see PIN 22-02CCP. 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Homes and the ADA, available at: http://www.ada.gov/childqanda.htm. (CONT. 809-C, Page 3)

NAME OF LICENSING PROGRAM MANAGER: Maria Mueller
NAME OF LICENSING PROGRAM ANALYST: Matthew Sapien
LICENSING PROGRAM ANALYST SIGNATURE:

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

DATE: 06/06/2025
LIC809 (FAS) - (06/04)
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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: CANCHE FAMILY CHILD CARE
FACILITY NUMBER: 406211893
VISIT DATE: 06/06/2025
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LPA discussed the safe sleep regulations with Facility Representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. Through interview and record review, LPA confirmed that the Facility Representative checks and documents napping infants every 15 minutes as required by the Department.

LPA also informed Facility Representative of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Facility Representative 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.

During today's visit, no deficiencies were issued.

During the exit interview, the Facility Representative confirmed that there are no Registered Sex Offenders living in the facility when the LPA completed an RSO profile in FAS on 6/6/25.

A notice of site visit was given and must remain posted for 30 days. Appeal rights were also given and signature on this form acknowledges receipt of these rights. Exit interview was conducted and report was reviewed with the Licensee, Mary Canche.

NAME OF LICENSING PROGRAM MANAGER: Maria Mueller
NAME OF LICENSING PROGRAM ANALYST: Matthew Sapien
LICENSING PROGRAM ANALYST SIGNATURE:

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

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