Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566212968
Report Date: 09/22/2015 12:00:00 AM
Date Signed 09/22/2015 02:34:05 PM

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:CENTENO FAMILY CHILD CAREFACILITY NUMBER:
566212968
ADMINISTRATOR:BEATRIZ CENTENOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 985-1849
CITY:OXNARDSTATE: CAZIP CODE:
93035
CAPACITY:14CENSUS: 7DATE:
09/22/2015
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Beatriz CentenoTIME COMPLETED:
02:48 PM
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3) Licensing Program Analyst (LPA) Michael Avila made an unannounced visit for the purpose of conducting an Annual Random facility inspection. LPA Avila met with Licensee Beatriz Centeno and discussed the nature and purpose of the visit. A tour of the facility was conducted with Licensee. No firearms are stored on the property. No bodies of water were observed on the property. The backyard is fully enclosed with a gated fence. Age appropriate toys were observed through out the property. No toxins nor hazards were observed accessible to children. A recently serviced 2A10BC fire extinguisher along with a smoke detector observed at the facility. Last emergency drill was conducted in August 2015. Children's records were reviewed and found current and complete. Public Notices were observed posted on the wall. LPA Avila explained Incidental Medical Services Plan of Operation Requirements with Licensee.

No deficiencies were issued during this unannounced facility inspection.

The visit was conducted in Spanish.
SUPERVISOR'S NAME: Patricia S. GutierrezTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Michael AvilaTELEPHONE: (805) 722-5133
LICENSING EVALUATOR SIGNATURE:

DATE: 09/22/2015
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2015
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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