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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334803735
Report Date: 06/14/2022
Date Signed: 06/14/2022 09:36:01 AM


Document Has Been Signed on 06/14/2022 09:36 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
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501



FACILITY NAME:KUPPANDA FAMILY CHILD CAREFACILITY NUMBER:
334803735
ADMINISTRATOR:KUPPANDA, VIREENAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(951) 371-8650
CITY:CORONASTATE: CAZIP CODE:
92882
CAPACITY:14CENSUS: 0DATE:
06/14/2022
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME BEGAN:
09:18 AM
MET WITH:Vireena Kuppanda, Licensee
Suresh Kuppanda, Licensee		TIME COMPLETED:
09:40 AM
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On June 14, 2022 Licensing Program Analysts (LPA) Elyse Jones conducted a Case Management-Legal Non-Compliance inspection. This inspection is in agreement with, and is a result of a Stipulation Decision dated September 10, 2021. The Stipulation Decision was initiated by citation issued regarding Personal Rights.

LPA met with Vireena Kuppanda & Suresh Kuppanda, toured the facility, and conducted a census.

The following were observed:
No children present during inspection
No Staff present during inspection
All residents who required a Criminal Record Clearance had one and were associated to the facility
Department received a compliance report on March 10, 2022

Based on the above, the facility was found to be in compliance with Title 22, at this time.

A NOTICE OF SITE VISIT WAS ISSUED AND IS TO BE POSTED IN A PROMINENT LOCATION AT THE FACILITY FOR THE NEXT 30 DAYS.
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Elyse JonesTELEPHONE: (951) 897-2468
LICENSING EVALUATOR SIGNATURE:
DATE: 06/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/14/2022
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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