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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 421710426
Report Date: 03/10/2023
Date Signed: 03/10/2023 03:11:05 PM

Document Has Been Signed on 03/10/2023 03:11 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:CLIFF DRIVE CARE CENTERFACILITY NUMBER:
421710426
ADMINISTRATOR:YZNAGA, JENNYFACILITY TYPE:
840
ADDRESS:1435 CLIFF DRIVETELEPHONE:
(805) 965-4286
CITY:SANTA BRBARASTATE: CAZIP CODE:
93109
CAPACITY: 45TOTAL ENROLLED CHILDREN: 45CENSUS: 0DATE:
03/10/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:44 PM
MET WITH:Jenny YznagaTIME COMPLETED:
03:21 PM
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On March 10th, 2023, at 2:44PM, Licensing Program Analysts (LPAs) Rosie Breault and Giovani Gonzalez made an unannounced visit for the purpose of conducting a Case Management - Incident inspection. LPA met with facility Director Jenny Ynzaga and discussed the purpose of the visit. At the time of the inspection there were zero (0) children, and three (3) staff present.

On 1/9/2023, staff contacted Community Care Licensing Division (CCLD) to self-report an incident of possible child on child touching. On 01/05/23 at around 4:00 PM, C1 and C2 were jumping off floor onto big cushions and C1 fell on to C2’s arm and were tangled. S1 visually saw the incident occur. After the incident, C1 disclosed to S1, that C2 touched her private area. S1 asked C1 if act was done on purpose, C1 indicated no and thought it was an accident.

During the inspection, S1 stated she was unable to contact parents however licensee spoke with both children’s parents. C1 parents took child to doctor who advised to file a police report. C1 parents did so but facility has not received report and parents did not disclose the outcome. Licensee advised LPAs C1 parent took child to doctor for an exam.

To date, C1 and C2 are currently enrolled, continue to play and there have been no further incidents with either children, parents or law enforcement.

No deficiencies were cited during today's visit.

THE NOTICE OF SITE VISIT WAS POSTED AS REQUIRED BY H&S CODE SEC. 1596.817. THE NOTICE OF SITE VISIT MUST REMAIN POSTED FOR 30 DAYS OR A CIVIL PENALTY OF $100.00 WILL APPLY.
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Maryrose Breault
LICENSING EVALUATOR SIGNATURE: DATE: 03/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/10/2023
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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