Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566212968
Report Date: 09/13/2017
Date Signed 09/13/2017 03:32:32 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: 12DATE:
09/13/2017
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
02:20 PM
MET WITH:Beatriz CentenoTIME COMPLETED:
03:45 PM
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LPA Avila made an unannounced visit for the purpose of conducting an Annual/Required facility visit. LPA Avila met with Licensee Beatriz Centeno and discussed the nature and purpose of the visit. LPA Avila toured the facility. LPA Avila observed 12 children in care at the time of the visit. Care of the children is primarily facilitated in the living room and den of the house. Licensee states there are no fire arms stored on the property. The backyard is fully enclosed with a fence. No bodies of water were observed on the property. Age appropriate toys and furniture were observed inside the house and in the backyard. No toxins nor hazards were found accessible to children in care. A 2A10BC fire extinguisher was observed mounted on the wall with a service date of 4/15/17. A smoke and carbon monoxide detector were observed in operating order. Children's records were reviewed and found current and complete. Licensee's CPR/First-Aid is current with an expiration date of 2/9/18. LPA discussed Incidental Medical Services Plan of Operation and vaccination requirements with Licensee.

No deficiencies were issued during this facility visit.

This facility 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: 09/13/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2017
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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