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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426216956
Report Date: 03/06/2026
Date Signed: 03/06/2026 03:42:57 PM

Document Has Been Signed on 03/06/2026 03:42 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:LOPEZ FAMILY CHILD CAREFACILITY NUMBER:
426216956
ADMINISTRATOR/
DIRECTOR:		LOPEZ, LETICIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 588-0716
CITY:LOMPOCSTATE: CAZIP CODE:
93436
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
03/06/2026
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:45 PM
MET WITH:Leticia LopezTIME VISIT/
INSPECTION COMPLETED:
04:00 PM
NARRATIVE
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On March 6, 2026 at 2:45 PM, Licensing Program Analysts (LPAs) Brian Fung and Fernando Hernandez made an unannounced inspection for the purpose of conducting a case management. LPA met with Leticia Lopez to discuss the purpose of the inspection. LPA toured the area where 4 children were found at the time of the inspection. During the inspection, upon LPAs entering the front door, LPAs found a lit candle on the dining table and match stix located next to the kitchen stove. Licensee's master bedroom was opened and perfumes and cleaning agents were found inside the room at a height level (2 feet) where children are able to reach. Licensees backyard play area, that children were seen to be playing, has coals, gardening tools, and propane gas. The shed in the backyard was unlocked and inside LPAs found cleaning agents, paint, and toxic items. During today’s inspection, an immediate risk was found regarding regarding. A type A violation was issued for making cleaning agents, detergents, toxic items, and other dangerous items that are would pose an immediate risk to children.

Exit interview and review of report was conducted with Licensee Leticia Lopez. Notice of site visit and appeal
rights were provided and must remain posted for the next 30 days. Type A Violation must be remain posted
for 1 year and current and potential families enrolled must signed acknowledgment agreement.

Also, LPAs Brian Fung and Fernando informed the licensee to provide a copy of this licensing report dated 3/6/2026 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.
NAME OF LICENSING PROGRAM MANAGER: Susana Martinez
NAME OF LICENSING PROGRAM ANALYST: Brian Fung
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 03/06/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/06/2026
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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Document Has Been Signed on 03/06/2026 03:42 PM - It Cannot Be Edited


Created By: Brian Fung On 03/06/2026 at 02:21 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: LOPEZ FAMILY CHILD CARE
FACILITY NUMBER: 426216956

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/06/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/06/2026
Section Cited
CCR
102417(g)(4)

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Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children.The requirement is not met as evidence by:
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Licensee will provide picture proof of correcitons to LPA and clear out all cleaning agents, gardening tools, propane gas and other toxin and dangerous other items that could pose a danger if readily available to children be stored in ...
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Based on observation and interview, the licensee left the master bedroom open which has a table full of perfumes and cleaning chemicals. The shed in the back yard was unlocked and contains cleaning chemicals and paint. Backyard was seen to have coal, propane, and gardening tools made accessible tochildren. A candle was lit on the dining table with match stix located in the kitchen where children had access as the gate was open. The bathroom shower was observed to have body cleansers and shampoos, which poses an a potential Health and/or, Safety and,Personal Rights risk to persons in care.
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a locked cabinet or shed to make inacessible to children by the end of day. Licensee will submit to LPA a letter indicating to discontinue the use of candles during operational hours and to keep poisons, detergency, cleaning compounds, medicine, and other items which could pose a danger if readily availbe to children in an inaccessible area of the home, such as a locked cabinet and submit the letter by the end of day. Licensee will temporarily close the backyard area and make it inaccessible to chidlren until the correction has been made.
CCR

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Susana Martinez
NAME OF LICENSING PROGRAM MANAGER:
Brian Fung
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 03/06/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/06/2026


LIC809 (FAS) - (06/04)
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