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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334819356
Report Date: 02/01/2022
Date Signed: 02/01/2022 09:28:19 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 ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:CROSSROADS CHRISTIAN PRESCHOOLFACILITY NUMBER:
334819356
ADMINISTRATOR:MORRISON, PENNYFACILITY TYPE:
850
ADDRESS:2380 FULLERTON AVENUETELEPHONE:
(951) 278-3196
CITY:CORONASTATE: CAZIP CODE:
92881
CAPACITY:252CENSUS: 86DATE:
02/01/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Monique GarciaTIME COMPLETED:
09:45 AM
NARRATIVE
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Licensing Program Analyst (LPA) Samuel Lopez arrived at the facility to follow up on a previous Case Management visit. Initially, on 1/20/2022, LPA Lopez conducted a case management visit in response to the receipt of an unusual incident report (UIR), regarding an incident involving inappropriate behavior between children in care. During that inspection, LPA toured the facility, specifically the classroom where the incident occurred, interviews were conducted, files were reviewed, and information was obtained surrounding the incident.

After the initial inspection and prior to today's arrival, LPA Lopez conducted additional interviews and obtained documentation regarding the details of the incident. LPA Lopez met with facility Assistant Director Monique Garcia, once again, toured the facility, and a census was taken of the children present. Additional Interviews were conducted.

After deciphering all the information obtained and based on the observations made, there were no violations of Title 22 identified.

A notice of site visit was given and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the Assistant Director Monique Garcia.

SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Samuel LopezTELEPHONE: (951) 897-2482
LICENSING EVALUATOR SIGNATURE:

DATE: 02/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2022
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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