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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 330911585
Report Date: 01/20/2022
Date Signed: 01/20/2022 11:42:41 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:RCOE - MORENO VALLEY HEAD STARTFACILITY NUMBER:
330911585
ADMINISTRATOR:CHRISTINE CHRESTFACILITY TYPE:
850
ADDRESS:16130 LASSELLETELEPHONE:
(951) 924-6974
CITY:MORENO VALLEYSTATE: CAZIP CODE:
92551
CAPACITY:34CENSUS: 0DATE:
01/20/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Jacquelyn Gonzalez -Site Secretary TIME COMPLETED:
11:30 AM
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Licensing Program Analysts, (LPAs) Rachel Zeron and Nasha King conducted a Case Management visit at the facility on this date to follow up on Confirmation of Removal for Griselda Toledo aka Griselda Vidal. The Confirmation of Removal was issued to the facility on 12/30/2021. LPAs identified themselves and stated the purpose of the visit. LPAs met with Jacquelyn Gonzalez, Site Secretary and Patricia Asevedo, Head Start and ECE Coordinator, by telephone. LPAs toured the facility; there were 0 children in care.

During the visit, LPAs reviewed the notification of Exclusion with Jacqueline Gonzalez, and Patricia Asevedo. A copy of the notification was provided to Jacqueline. LPAs explained the written confirmation of removal for Griselda Toledo aka Griselda Vidal. The Site secretary stated Griselda Toledo aka Griselda Vidal does not work at the facility, nor has she ever worked at the facility.

LPAs advised the Site Secretary that the Confirmation of Removal letter needs to be acknowledged and signed. LPAs informed Site Secretary and Coordinator that all adults who work at the facility must be fingerprint cleared and associated to the facility prior to working at the facility. There were no citations issued during this visit.

An exit interview was conducted, a Notice of Site Visit posted. And a copy of this report was provided to the Site Secretary on this date.
SUPERVISOR'S NAME: Stephanie HudakTELEPHONE: (951) 320-2021
LICENSING EVALUATOR NAME: Rachel ZeronTELEPHONE: (951) 782-4207
LICENSING EVALUATOR SIGNATURE:

DATE: 01/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/20/2022
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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