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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426216015
Report Date: 07/23/2024
Date Signed: 07/23/2024 03:59:29 PM

Document Has Been Signed on 07/23/2024 03:59 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:MUNIZ FAMILY DAY CAREFACILITY NUMBER:
426216015
ADMINISTRATOR/
DIRECTOR:		MARIA ELENA MUNIZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 862-9417
CITY:SANTA MARIASTATE: CAZIP CODE:
93455
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 10DATE:
07/23/2024
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:37 PM
MET WITH:Maria Elena MunizTIME VISIT/
INSPECTION COMPLETED:
04:15 PM
NARRATIVE
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On 7/23/2024 at 3:37 PM Licensing Program Analyst (LPA) Gigi Reyes conducted an unannounced Case Management (Legal) inspection and met with Family Child Care Home (FCCH) co-Licensee Maria Elena Muniz, LPA discussed the purpose of the inspection. LPA and Licensee toured the home, there were 9 day care children under the care of co-Licensee, Maria Elena Muniz. Co-Licensee Antoinette arrived with Child # 10 with her.

The purpose of the inspection is to deliver the following Accusation CDSS No. 7824093004. The summary of Accusation was Criminal Record Exemption Denial
was discussed with licensee.

A copy of this Accusation must be posted for 30 day and shall be provided to the parent/guardian of currently enrolled child by the next business day or immediately upon return as well as the parent/guardian of any enrolled child until the accusation is either dismissed or resolved through the administrative hearing or stipulated agreement.

A notice of site visit was given to Licensee, Antoinette Muniz and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

Exit interview conducted and report was reviewed with the Licensee, Antoinette Muniz
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE: DATE: 07/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/23/2024
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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