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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406216408
Report Date: 06/12/2023
Date Signed: 06/12/2023 09:09:05 PM

Document Has Been Signed on 06/12/2023 09:09 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:RAMIREZ FCC AKA SUN COAST KIDSFACILITY NUMBER:
406216408
ADMINISTRATOR:LISBETH RAMIREZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 904-3569
CITY:GROVER BEACHSTATE: CAZIP CODE:
93433
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
06/12/2023
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Lisbeth RamirezTIME COMPLETED:
10:30 AM
NARRATIVE
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On 6/12/23, at 9:45 AM , Licensing Program Analyst (LPA) Elvin Baddley attempted to conduct an unannounced Case Management Inspection (Legal) of the abovementioned Family Child Care Home (FCCH) the deliver the Licensee to provide LIC 9224 for each child in care and have each parent sign the form that they have received a copy of the In the matter of Lenthonio Stevenson Ramirez and the Licensee, Lisbeth Ramirez (CDSS No. 6423025101, CDSS No. 6423025101B, CDSS No. 6423025101C and CDSS No. 6423025101D).

LPA knocked on the residence door several times and called the contact number of record. LPA received a voicemail message upon contacting phone number of record. LPA left a message requesting a return call. LPA left the facility after leaving a business card in the door jamb of the FCCH's entry door. LPA also text messaged Licensee informing of the aforementioned. Licensee responded to the text message and informed LPA the FCCH is closed as there are COVID exposures in the home. Via text message, Licensee informed LPA the FCCH would be closed for two weeks given the COVID exposures and the documentation LPA was planning to deliver could be left at the FCCH's door.

LPA generated this report and left the report along with a copy of the Accusation mentioned above at the FCCH's door in a manila envelope. A second manila envelope was left at the FCCH's door containing an Application form (LIC 279) and an Unusual Incident Report form (LIC 624) to be completed by the Licensee and returned to CCLD. A photo of the manila envelopes were taken at the FCCH's door and the LPA forwarded the LPA a text message informing of the documents left at the entry at entry door.

Licensee to provide LIC 9224 for each child in care and have each parent sign the form that they have received a copy of the Accusation. Licensee provided Appeal Rights.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE: DATE: 06/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/12/2023
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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