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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334819141
Report Date: 09/03/2020
Date Signed: 10/02/2020 03:56:21 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 ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:RAMIREZ-RUIZ FAMILY CHILD CAREFACILITY NUMBER:
334819141
ADMINISTRATOR:RAMIREZ-RUIZ, NUBIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 795-9646
CITY:CALIMESASTATE: CAZIP CODE:
92320
CAPACITY:14CENSUS: 6DATE:
09/03/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Nubia Ramirez-RuizTIME COMPLETED:
04:00 PM
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Due to COVID-19 State of Emergency, on 09/03/2020 at 3:30pm, Licensing Program Analyst (LPA) Destinee Hogue conducted a case-management tele-inspection with Licensee Nubia Ramirez-Ruiz via Zoom. Present during this tele-inspection were LPA Hogue, Licensee, Licensee's Spouse, Licensee's adult daughter, and six daycare children. LPA toured the facility inside and outside (video conference), conducted census, reviewed records, and discussed the following with Licensee:

On 09/03/2020, LPA Hogue conducted a COVID-19 Technical Assistance (TA) tele-inspection with Licensee Nubia Ramirez-Ruiz. During the COVID-19 TA tele-inspection, Licensee disclosed that her adult son who resides in the home, has recently turned 18 years old and hasn't obtained a criminal record clearance or criminal record exemption.

Licensee submitted the following to LPA Hogue; LIC9163 (Request for Live Scan), LIC508 (Criminal Record Statement), and receipt showing proof Licensee's son was fingerprinted on 09/03/2020. Licensee agreed to mail the above documents to the Riverside Regional Office. An Advisory Note-Technical Violation notice was issued. No deficiencies were cited during this tele-inspection.

An exit interview was conducted via Zoom. A Notice of Site Visit and a copy of this report was provided to Licensee on this date. Due to COVID-19 State of Emergency, LPA provided a copy of this report via email with an electronic “READ RECEIPT”. LPA Hogue requested the Licensee to acknowledge receipt of the email. The electronic read receipt of the emailed report acknowledges receipt of this report. Licensee understands that a copy of this report must be made available to the public, upon their request, for the next three years.
SUPERVISOR'S NAME: Kimberly WilliamsTELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Destinee HogueTELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:

DATE: 09/03/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2020
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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