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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426209722
Report Date: 09/28/2026
Date Signed: 09/28/2026 11:51:02 AM

Document Has Been Signed on 09/28/2026 11:51 AM - 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:VASQUEZ FCC AKA BUMBLEBEE DAYCAREFACILITY NUMBER:
426209722
ADMINISTRATOR/
DIRECTOR:		ANNYVETTE VASQUEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 925-0365
CITY:SANTA MARIASTATE: CAZIP CODE:
93454
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
09/28/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:09 AM
MET WITH:Annyvette VasquezTIME VISIT/
INSPECTION COMPLETED:
12:06 PM
NARRATIVE
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On September 28, 2026 at 9:09 AM, Licensing Program Analyst (LPA) Bill Billones conducted an unannounced Annual Random inspection at the above referenced Family Child Care Home (FCCH). LPA met with Licensee Annyvette Vasquez and explained the purpose of today’s visit. LPA in the company of the Licensee toured the physical plant inside and outside and observed required documents posted in the hallway. Licensee confirmed hours of operation are from 7:30 AM to 5:00 PM, Monday through Friday. At arrival LPA observed three (3) children present under the care and supervision of the Licensee (associated and cleared).

The residence is a two-story home with three bedrooms, on additional bedroom used as an office, two bathrooms, a living room, family room, kitchen and dining area, and an attached garage. The FCCH operates out of the family room, kitchen and dining area, one bathroom, and the backyard, while the remainder of the home is excluded from child care services. LPA observed the accessible areas of the day care to be clean and orderly, with adequate spacing and ventilation. Age-appropriate toys, furnishings, and equipment were observed throughout the home. LPA notes the front living room is accessible to children in care. Multiple opened and unopened bottles of alcohol were observed in this area; the Licensee removed and secured the opened bottles during the inspection. Additionally, the front living room contains one unsecured screened fireplace. LPA observed the family room is enclosed by children’s gates and serves as the primary area for children’s activities. A secured potbelly stove was observed in the family room. LPA notes one lower kitchen cabinet is secured with child locks and contains cleaning supplies. Cooking knives were observed on the counter and were moved to a secure location by the Licensee during the inspection. Additional sharps were observed stored in an elevated kitchen cabinet, out of children’s reach. The day care bathroom was observed to be in sanitary condition; however, cabinets and drawers were unlocked and contained multiple personal care and hygiene products labeled “keep out of reach of children.” The Licensee secured these items during the inspection. Continued on LIC809-C

Ana Tolentino
Bill-Brian Billones
DATE: 09/28/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/28/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 5
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: VASQUEZ FCC AKA BUMBLEBEE DAYCARE
FACILITY NUMBER: 426209722
VISIT DATE: 09/28/2026
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LPA observed that the staircase is gated at the bottom to prevent access to the second story, which is completely off-limits to children in care. Doors to one off-limits bedroom and the office on the first floor were observed with locking mechanisms to restrict access. LPA reminded the Licensee that all hazardous items must be secured and kept inaccessible to children while care is being provided.

A dual carbon monoxide and smoke detector was tested in the kitchen at 9:48 AM and was found to be functional. LPA observed a regulation fire extinguisher (3A40BC) with a purchase receipt dated 04/23/2026. LPA notes disaster drills are regularly conducted with the last fire drill documented on 03/13/2026. LPA reminded Licensee to purchase or service the fire extinguisher yearly and to conduct disaster drills every 6 months.

Backyard area is fully enclosed. Outdoor age-appropriate outdoor toys and equipment for children’s use were observed to be in good repair. Multiple locked sheds were observed for personal storage. LPA notes there is an off-limit section of the backyard secured by children’s gate for the storage of the Licensee’s personal items. Backyard has a firepit and barbecue pits that are covered and made inaccessible. LPA observed one body of water - a hot tub in the backyard. Hot tub is covered with chains locking the cover to the ground. LPA observed one dog in the home, which Licensee states vaccines are current. LPA was informed there are firearms and ammunition in the home, which are stored in a safe located in an off-limits area. LPA discussed the regulation for keeping firearms and ammunition stored separately.

A sample of children and staff records were reviewed, which were found to be complete with all required licensing documents. LPA verified the children’s roster is maintained. LPA reminded Licensee to document immunization and transfer records to the form PM286. Licensee states 15-minute sleep checks are conducted for infants up to 12 months. Safe sleep regulations were discussed. Currently licensee operates as a small family child care and does not employ additional personnel. Licensee’s Pediatric First Aid/CPR certificate expires on 04/23/2028 and their Mandated Reporter training certificate expires on 06/27/2027. Licensee was reminded to keep training certifications current and updated prior to expirations.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. Continued on LIC809-C

NAME OF LICENSING PROGRAM MANAGER: Ana Tolentino
NAME OF LICENSING PROGRAM ANALYST: Bill-Brian Billones
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/28/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2026
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: VASQUEZ FCC AKA BUMBLEBEE DAYCARE
FACILITY NUMBER: 426209722
VISIT DATE: 09/28/2026
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A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with Licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed Licensee of the importance of checking for and removing any recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the Licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to [email protected]. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

In areas evaluated, one Type B deficiency is being cited and can be found the attached LIC809-D.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Licensee Annyvette Vasquez.

NAME OF LICENSING PROGRAM MANAGER: Ana Tolentino
NAME OF LICENSING PROGRAM ANALYST: Bill-Brian Billones
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/28/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2026
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 09/28/2026 11:51 AM - It Cannot Be Edited


Created By: Bill-Brian Billones On 09/28/2026 at 11:12 AM
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: VASQUEZ FCC AKA BUMBLEBEE DAYCARE
FACILITY NUMBER: 426209722

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/28/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(4)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) 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.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above in personal hygiene items were accessible to children in the bathroom, sharps and knives were accessible to children in the kitchen, and bottles of alcohol were within children's reach in the living room, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/08/2026
Plan of Correction
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Licensee secure sharps, opened alcohol bottles, and personal care items during the inspection. Licensee is to ensure unopened alcohol bottles and other items that are potentially hazardous to children inaccessible and send proof via email to [email protected] no later than October 8, 2026.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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.
Ana Tolentino
NAME OF LICENSING PROGRAM MANAGER:
Bill-Brian Billones
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 09/28/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/28/2026


LIC809 (FAS) - (06/04)
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