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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
334816521
Report Date:
09/23/2019
Date Signed:
09/23/2019 12:11:28 PM
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:
LEE FAMILY CHILD CARE
FACILITY NUMBER:
334816521
ADMINISTRATOR:
LEE, OMARRA
FACILITY TYPE:
810
ADDRESS:
TELEPHONE:
(951) 242-8872
CITY:
MORENO VALLEY
STATE:
CA
ZIP CODE:
92551
CAPACITY:
14
CENSUS:
DATE:
09/23/2019
TYPE OF VISIT:
Office
UNANNOUNCED
TIME BEGAN:
10:00 AM
MET WITH:
Omarra Lee
TIME COMPLETED:
11:00 AM
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Licensing Program Analyst (LPA) Yolanda Jackson assessed Civil Penalties from the citation that was issued on 6/19/19.
SUPERVISOR'S NAME:
Telma Sandoval
TELEPHONE:
(951) 782-4950
LICENSING EVALUATOR NAME:
Yolanda Jackson
TELEPHONE:
(951) 201-1991
LICENSING EVALUATOR SIGNATURE:
DATE:
09/23/2019
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
09/23/2019
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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