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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406217636
Report Date: 11/18/2025
Date Signed: 11/18/2025 12:32:18 PM

Document Has Been Signed on 11/18/2025 12:32 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:PASCUAL FAMILY CHILD CAREFACILITY NUMBER:
406217636
ADMINISTRATOR/
DIRECTOR:
PASCUAL, ABIGAILFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 536-9249
CITY:PASO ROBLESSTATE: CAZIP CODE:
93446
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
11/18/2025
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Abigail PascualTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
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On 11/18/25, at 10:00 AM, Licensing Program Analyst (LPA) Matthew Sapien conducted an announced pre-licensing visit of the abovementioned residence and met with Applicant, Abigail Pascual. LPA informed Applicant of the nature and purpose of the inspection. Applicant informed LPA of the intention to maintain operating hours of a Family Childcare Home (FCCH) from 7:00 AM until 5:00 PM, Monday through Friday. Applicant also intends to care for children 0 years of age to 12 years of age. Applicant was informed changes in licensing hours and/or the ages of children supervised and cared for can be altered upon notifying CCLD of the given modifications and/or changes. LPA observed only the Applicant on site at the time of the inspection (cleared and associated). There is currently one adult residing in the home and said adult is cleared through The Guardian website.

LPA, in the company of Applicant, toured the interior and exterior of the single story residence unit in its entirety. The residence has 2 bedrooms, 1 1/2 bathrooms, living room, kitchen, front yard, and backyard. The areas to be used for childcare within the residence is the living room (main play room), kitchen, one bathroom, one bedroom (napping and secondary play room), front yard, and backyard. The remainder of the home is excluded from childcare services, including the master bedroom and master bathroom. Importantly to note, child safety knobs, gates, and latches will be added to drawers and rooms that are inaccessible for children in care.

·LPA observed a regulation fire extinguisher (2A10BC) in the area for childcare. The receipt for the fire extinguisher could not be retrieved at the time of the inspection and will be sent to the LPA as soon as it's found. LPA reminded Applicant of the responsibility to service or purchase a regulation fire extinguisher annually.

· The residence has a couple of combination smoke and carbon monoxide detectors throughout the home. Near the kitchen area, a detector was tested at 11:20 AM and was found to be operational.

NAME OF LICENSING PROGRAM MANAGER: Maria Mueller
NAME OF LICENSING PROGRAM ANALYST: Matthew Sapien
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 11/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/18/2025
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: PASCUAL FAMILY CHILD CARE
FACILITY NUMBER: 406217636
VISIT DATE: 11/18/2025
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·LPA observed the residence to be clean and orderly.

·LPA observed no pets present on site.

· In the backyard area, LPA observed a swing set and other toys and equipment appropriate for children in care.

· LPA observed the footing of the front yard and backyard to be made up of concrete pavement, sand, and some artificial turf. LPA also observed an umbrella in the front and backyards. During the warm seasons of the year, shade will also be afforded with canopies. Applicant will need to add child safety gates to the sides of the backyard and front yard to ensure proper supervision of children in care. In the backyard, Applicant will also need to add a barrier or gate in front of the electrical meter box.

· LPA observed no bodies of water on site and confirmed that this was the case with the Applicant.

·Applicant informed LPA that no firearms or ammunition are present on site.

·LPA observed no fireplaces in the space.

·The residence has proper space and ventilation for children in care.

·The restroom to be used for children in care is observed to be clean and free of toxins. A child safety gate should be added to the back part of the restroom preventing access to the dryer and washer.

·Sharps are stored in an unlocked kitchen cabinet. A child safety latch will be added to the cabinet due to it being in reach for children in care.

·Personal medications are stored in an elevated kitchen cabinet.

·Chemicals and cleaning supplies are also stored in elevated kitchen cabinets.

·Filtered water will be provided via bottled gallons of water.

LPA record review revealed Applicant's documents noted below.

·CCLD orientation certificate was obtained on 6/18/25.

·Applicant completed Preventative Health Training on 8/14/25.

·Pediatric CPR/First Aid was completed on 7/14/25 (expiration 7/14/27).

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

DATE: 11/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2025
LIC809 (FAS) - (06/04)
Page: 3 of 6
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: PASCUAL FAMILY CHILD CARE
FACILITY NUMBER: 406217636
VISIT DATE: 11/18/2025
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·Mandated Reporter training was completed on 7/10/25 (expiration 7/10/27)

·LPA reminded Applicant of obligation to maintain current training and certifications.

Applicant Abigail Pascual was reminded that no prohibited equipment will be allowed or used in the home. No baby bouncers, No infant walkers, No Johnny jumpers, No saucer chairs, No trampolines or any other item that falls into that category are not permitted in the facility.

Applicant Abigail Pascual 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.

The control of property was reviewed. Because the Applicant rents/leases the home, a proof of landlord notification is required. LPA observed the Property Owner/Landlord Notification Form (LIC 9151) that the Applicant confirmed was provided to the property owner/landlord. LPA also viewed a signed Property Owner/Landlord Consent form (LIC 9149).



Applicant states she will be offering Incidental Medical Services (IMS) as needed. Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 2202-CCP. 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 (TW} and link to publication: Commonly Asked Questions about Family Child Care Homes and the ADA, available at http://www.ada.gov/childqanda.htm.

LPA reviewed with Applicant the LIC 311D, Forms/Records to Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. The Entrance Checklist (LIC 126) was also provided to the Applicant. LPA discussed the safe sleep regulations with Applicant and discussed the Child Care Licensing Safe Sleep webpage at:https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource.

LPA also informed Applicant 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

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

DATE: 11/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2025
LIC809 (FAS) - (06/04)
Page: 4 of 6
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: PASCUAL FAMILY CHILD CARE
FACILITY NUMBER: 406217636
VISIT DATE: 11/18/2025
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register all infant devices with the CPSC to be notified of any recalls of infant devices or their purchased equipment.

On this date, 11/18/25, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility address. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California. Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PINs), Program Quarterly Update Newsletters, and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communications.

A Small FCCH License (8 children in care) will be granted upon submission of the following corrections:

  • An updated Property Owner/Landlord Consent Form (LIC 9149) needs to be submitted due to the Applicant initially applying for a Large FCCH License, rather than a Small FCCH License.
  • A child safety latch needs to be attached to the kitchen cabinet that stores sharps or any other item that could be potentially hazardous for children in care.
  • Plastic child safety knob covers must be added to the kitchen stove.
  • A child safety gate or some form of a secure barrier needs to be added to a part of the bathroom which doesn't allow for children to have access to the dryer and washing machine.
  • In the guest bedroom that will be accessible for children, the room should be configured more in a way that is suitable for play and sleep.
  • The master bedroom shall have a child proof door lock added to the handle.
  • Child safety gates or some secure form of barrier need to be added to the sides of the backyard and the front yard as well.
NAME OF LICENSING PROGRAM MANAGER: Maria Mueller
NAME OF LICENSING PROGRAM ANALYST: Matthew Sapien
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2025
LIC809 (FAS) - (06/04)
Page: 5 of 6
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: PASCUAL FAMILY CHILD CARE
FACILITY NUMBER: 406217636
VISIT DATE: 11/18/2025
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  • In the front yard, a portion of the gate needs to be closed off.
  • In the backyard, Applicant will also need to add some secure form of barrier or gate in front of the electrical meter box.
  • The Applicant must submit a picture of the receipt for the purchased regulation fire extinguisher.
  • An Influenza (Flu) shot declination letter must be submitted.

The Applicant must submit these plans of correction by 12/2/25 before the close of business day.

A notice of site visit was given to the Applicant and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Exit interview conducted and report was reviewed with the Applicant, Abigail Pascual.

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

DATE: 11/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2025
LIC809 (FAS) - (06/04)
Page: 6 of 6