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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334808418
Report Date: 12/05/2022
Date Signed: 12/05/2022 12:30:21 PM


Document Has Been Signed on 12/05/2022 12:30 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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501



FACILITY NAME:ANDREWS FAMILY CHILD CAREFACILITY NUMBER:
334808418
ADMINISTRATOR:ANDREWS, SOUHERFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 322-2607
CITY:CATHEDRAL CITYSTATE: CAZIP CODE:
92234
CAPACITY:14CENSUS: 0DATE:
12/05/2022
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
11:08 AM
MET WITH:Souher Andrews and Spouse Maged AndrewsTIME COMPLETED:
12:30 PM
NARRATIVE
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An Informal Conference was held in the Riverside Child Care Regional Office on this date, December 5, 2022. Present in the conference were Licensee Souher Andrews, Licensee's spouse Maged Andrews, Licensing Program Manager (LPM), Aaron Ross, and Licensing Program Analyst (LPA) Samuel Lopez.

The Conference was called to discuss the facility's most recent issues of:
1. Criminal Record Clearance
2. Inspection Authority
3. Licensee Responsibilities

The Licensee agrees to contact Riverside County Office of Education/Resource and Referral to enroll and participate in formal training regarding Operation of a Family Child Care Home.
Proof enrollment to be submitted by December 23, 2022 and proof of completion by February 1, 2023 to the Riverside Child Care Regional office.

Riverside County Office of Education (RCOE) Resource and Referral contact: 951-826-6626/800-442-4927

SEE Videos: https://ccld.childcarevideos.org/family-child-care-providers/

- Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at: https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Samuel LopezTELEPHONE: (951) 897-2482
LICENSING EVALUATOR SIGNATURE:
DATE: 12/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/05/2022
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 3


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: ANDREWS FAMILY CHILD CARE
FACILITY NUMBER: 334808418
VISIT DATE: 12/05/2022
NARRATIVE
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As a result of this informal conference, Licensee Souher Andrews understands the department’s expectations and agrees to maintain substantial compliance with Title 22 Regulations. Also, a citation for Inspection Authority, related to the Annual Inspection conducted on 11/1/2022, is being issued.

See LIC809-D for cited deficiency

LPA Samuel Lopez informed licensee Souher Andrews that this report dated December 5, 2022 document(s) (1) Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Samuel Lopez informed the licensee Souher Andrews to provide a copy of this licensing report dated December 5, 2022 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Exit interview conducted and report was reviewed with the licensee Souher Andrews.
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Samuel LopezTELEPHONE: (951) 897-2482
LICENSING EVALUATOR SIGNATURE:

DATE: 12/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2022
LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 12/05/2022 12:30 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501


FACILITY NAME: ANDREWS FAMILY CHILD CARE
FACILITY NUMBER: 334808418

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/05/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/06/2022
Section Cited

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Inspection Authority of the Department: Any duly authorized officer, employee, or agent of the Department shall, upon presentation of proper identification, enter and inspect any place providing personal care, supervision, and services at any time, with or without advance notice, to secure
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compliance with, or to prevent a violation of, the regulations adopted by the Department governing family child care homes, and in accordance with Section 102396. Based on actions that took place on 11/1/2022, the licensee did not comply with the section cited above.
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The licensee's spouse requested that the Licensing Program Analyst (LPA) Samuel Lopez leave the home. LPA complied and did not complete the inspection. This poses an immediate health, safety or personal rights risk to persons in care.

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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.
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Samuel LopezTELEPHONE: (951) 897-2482
LICENSING EVALUATOR SIGNATURE:
DATE: 12/05/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/05/2022
LIC809 (FAS) - (06/04)
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