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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426216264
Report Date: 12/19/2023
Date Signed: 12/19/2023 02:05:28 PM

Document Has Been Signed on 12/19/2023 02:05 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:FONSECA FAMILY CHILD CAREFACILITY NUMBER:
426216264
ADMINISTRATOR:YADIRA FONSECAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 757-1067
CITY:LOMPOCSTATE: CAZIP CODE:
93436
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
12/19/2023
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Yadira FonsecaTIME COMPLETED:
10:15 AM
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On 12/19/2023 at 9:45 AM, Licensing Program Analysts (LPAs) Gigi Reyes and German Negrete conducted an unannounced Case Management Legal/Non-compliance inspection of the facility. The purpose of today's inspection was to review and deliver the legal documents to Licensee, Decision and Order CDSS No. 7923271009 effective 12/21/2023.

LPAs met with Licensee and explained the nature of the visit. LPAs observed nine (9) children in care at the time of the inspection. The Decision and Order stipulate tha tthe individual, Rosa Garcia is excluded from all licensed facilities for the remainder of the individual's life

Licensee responded that the above mentioned individual was never employed in her facilities and she requested that name of the individual be removed from her forwarded a personnel her Family Child Care Home's personnel roster.

Exit interview conducted and report was reviewed with Licensee, Yadira Fonseca

A Notice of Site Visit (LIC 9213) along with Appeal Rights (LIC 9058) were given to the Licensee.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE: DATE: 12/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/19/2023
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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