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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406216574
Report Date: 06/22/2023
Date Signed: 06/22/2023 01:58:49 PM

Document Has Been Signed on 06/22/2023 01:58 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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:RAMIREZ FAMILY CHILD CARE HOMEFACILITY NUMBER:
406216574
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 6CENSUS: 4DATE:
06/22/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:05 PM
MET WITH:Vanessa RamirezTIME COMPLETED:
02:10 PM
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On 6/22/23, at 1:05 Licensing Program Analyst (LPA) Martina Jimenez conducted an unannounced Case Management inspection for the purpose of a change of capacity. LPA met with Vanessa Ramirez, Licensee of the FCCH and explained the nature/purpose of the inspection.

During this inspection, LPA and Licensee together toured the an interior and exterior of the FCCH. LPA observed the FCCH's interior and exterior to be free of hazardous materials and/or toxins at the time of the visit. LPA observed 4 children in care at the time of the inspection.

LPA reviewed the Licensee’s First Aid/ CPR certification which expires on 2/22/2025. LPA observed a regulation fire extinguisher which was serviced on 03/17/2023. LPA reviewed the Licensee’s Mandated Reporter Training certificate, which was completed on 07/14/2021.

On 5/25/2023, the Licensee submitted application for a change of capacity. The Licensee is seeking to change the FCCH’s capacity from 8 (Small FCCH) to 14 (Large FCCH). The Atascadero Fire Department granted a fire clearance following an inspection completed at FCCH on 6/2/2023.

The home meets Title 22 of CCR requirements for a Large Family Child Care license effective today. Effective date of license is today June 22, 2023.



THIS REPORT MUST BE FILED IN FACILITY FILE AND MADE AVAILABLE FOR PUBLIC REVIEW FOR 3 YEARS. LPA observed the "Notice of Site Visit" posted. FAILURE TO POST THE NOTICE OF SITE VISIT FOR 30 DAYS MAY RESULT IN A $100.00 CIVIL PENALTY.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Martina Jimenez
LICENSING EVALUATOR SIGNATURE: DATE: 06/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/22/2023
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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