426216478-8-19-2025-17-CC-MSAN-DKPRSN-20250819131700

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 426216478
Report Date: 08/19/2025
Date Signed: 08/19/2025 01:17:13 PM

Document Has Been Signed on 08/19/2025 01:17 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:	CAMACHO FAMILY CHILD CARE		FACILITY NUMBER:	426216478
ADMINISTRATOR/ DIRECTOR:	MARICELA CAMACHO		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 332-0771
CITY:	SANTA MARIA	STATE: CA	ZIP CODE:	93458
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 1	DATE:	08/19/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	11:50 AM
MET WITH:	Maricela Camacho		TIME VISIT/ INSPECTION COMPLETED:	02:00 PM

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On 8/19/25, at 11:50 AM, Licensing Program Analysts (LPAs) Matthew Sapien and Seena Parsapour conducted an unannounced annual random inspection visit of the abovementioned Family Child Care Home (FCCH). LPAs met with Maricela Camacho, Licensee of the FCCH, and explained the nature and purpose of the inspection. The LPAs, in the company of Licensee, toured the interior and exterior of the FCCH. The home is a 4 bedroom and 3 bathroom two story home. The areas that are accessible for day care children are as follows: living room, one guest bedroom (play room), dining room, and backyard. The remainder of the home is excluded from childcare services. At the time of the inspection, LPAs observed 1 day care child present. At the time of the inspection, LPAs also observed the Licensee's husband (cleared and associated) assisting with the care and supervision of children.

LPAs observed the FCCH to be clean and orderly. The bathroom, utilized for childcare, is clean and free of toxins. LPAs observed child safety latches on each of the bathroom cabinets. LPAs observed sharps stored in the kitchen area in elevated cabinets and on top of the fridge. Family medication is also stored in elevated kitchen cabinets. No children currently require medication. Cleaning solutions are primarily stored in an elevated space within the garage.

LPAs observed age-appropriate toys, furnishings, and equipment throughout the interior of the FCCH. In the living room and guest bedroom, LPAs observed a number of storage compartments each of which contained items related to the day care. In the living room, LPAs observed a fireplace that is enclosed by glass and has child safety latches added. LPAs observed no animals present on site.

LPAs observed relevant licensing forms and documents posted prominently at the entryway of the residence. LPAs observed smoke and carbon monoxide detectors within the household. The smoke detector was tested (CONT. 809-C, Page 2)

NAME OF LICENSING PROGRAM MANAGER: Maria Mueller
NAME OF LICENSING PROGRAM ANALYST: Matthew Sapien
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/19/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2025

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: CAMACHO FAMILY CHILD CARE	FACILITY NUMBER: 426216478
	VISIT DATE: 08/19/2025

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at 12:13 PM and the carbon monoxide detector was tested at 12:12 PM. Each were found to be operational. LPAs observed a regulation fire extinguisher in the FCCH which was last serviced on 5/28/25. LPAs reminded the Licensee to either service or purchase a regulation fire extinguisher annually. LPAs reviewed the FCCH's fire/disaster drill log. The most recent disaster drill occurred on 6/10/25. LPAs reminded the Licensee that disaster drills must be conducted every six months per Department regulations.

As aforementioned, the backyard is accessible to children in care. This area is fully enclosed by wooden fencing. The fence’s entry and exit gates are secure. The footing of the backyard area is made up of concrete pavement and natural grass. Like the interior of the FCCH, childcare toys, structures, and play equipment observed in the outdoor area are age appropriate and are in satisfactory condition. In the backyard, shade is afforded by canopies and by the house itself. LPAs observed no bodies of water on site and confirmed that this was the case with the Licensee. LPAs reminded the Licensee of the importance of direct supervision over children in care and to conduct inspections of outdoor areas prior to letting children outside.

LPAs 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. LPAs found that the Licensee completed their CPR/First Aid Training (EMSA approved) on 6/7/24 and their Mandated Reporter Training on 9/13/24. Licensee was reminded to renew certifications and training prior to expirations. The Licensee informed LPAs that there are no firearms or ammunition that are stored on site.

The Licensee 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 Family Child Care Homes and the ADA, available at: http://www.ada.gov/childqanda.htm.

LPAs discussed the safe sleep regulations with Licensee 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. The Licensee does not currently care for infants that are 24 months and under. LPAs also informed the Licensee 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 (CONT. 809-C, Page 3)

NAME OF LICENSING PROGRAM MANAGER: Maria Mueller
NAME OF LICENSING PROGRAM ANALYST: Matthew Sapien
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/19/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2025

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: CAMACHO FAMILY CHILD CARE	FACILITY NUMBER: 426216478
	VISIT DATE: 08/19/2025

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Licensee 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 Licensee confirmed that there are no Registered Sex Offenders living in the facility when the LPAs completed an RSO profile in FAS on 8/19/25.

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, Maricela Camacho.

NAME OF LICENSING PROGRAM MANAGER: Maria Mueller
NAME OF LICENSING PROGRAM ANALYST: Matthew Sapien
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/19/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2025

LIC809 (FAS) - (06/04)

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