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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334819908
Report Date: 10/15/2020
Date Signed: 10/15/2020 10:34:37 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:RUSD/HAWTHORNE ELEMENTARY SCHOOLFACILITY NUMBER:
334819908
ADMINISTRATOR:CARRIE BROWNFACILITY TYPE:
850
ADDRESS:2700 IRVING STREETTELEPHONE:
(951) 352-6716
CITY:RIVERSIDESTATE: CAZIP CODE:
92504
CAPACITY:24CENSUS: 0DATE:
10/15/2020
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
09:55 AM
MET WITH:Luz RomeroTIME COMPLETED:
10:45 AM
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On 10/15/2020, Licensing Program Analyst (LPA) Samuel Lopez conducted a Case Management inspection due to a request for a classroom change. During today's inspection, LPA Lopez met with Luz Romero (Early Childhood Services Specialist), which provided access to the campus and classroom. A request for room change was received on 9/14/2020 and a Fire Clearance was granted on 9/30/2020. The Preschool Program is being moved to Room H102 from Room 27 without a capacity change.

***Please note that at there are no children currently in attendance due to COVID-19 restrictions***

Preschool (RM H102) Indoor Activity Area
LPA has determined that there is sufficient space to accommodate 24 children.

Preschool Bathroom Fixtures
2 toilets x 15 = 30 children
3 sinks x 15 = 45 children
***Please note: There is a pre-existing waiver for the Preschool children to share restrooms with the Kindergarten children while on the playground***

Preschool Outdoor Activity Area
LPA has determined that there is sufficient space to accommodate 24 children.
***Please note: There is a pre-existing waiver for the Preschool children to share the playground with the Kindergarten children***

Limiting factor for preschool capacity is Fire Clearance. Preschool capacity is limited to 24 children.
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Samuel LopezTELEPHONE: (951) 897-2482
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2020
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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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: RUSD/HAWTHORNE ELEMENTARY SCHOOL
FACILITY NUMBER: 334819908
VISIT DATE: 10/15/2020
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A NOTICE OF SITE VISIT WAS ISSUED AND IS TO BE POSTED IN A PROMINENT LOCATION AT THE FACILITY FOR THE NEXT 30 DAYS.

No deficiencies observed/cited during this inspection.

A copy of this report was provided to Luz Romero on this date and must be made available to the public upon request for the next 3 years.
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Samuel LopezTELEPHONE: (951) 897-2482
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2020
LIC809 (FAS) - (06/04)
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