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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334819985
Report Date: 05/20/2020
Date Signed: 05/20/2020 04:01:59 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:MELODY LANE CHILDRENS CENTERFACILITY NUMBER:
334819985
ADMINISTRATOR:JULIE BACAFACILITY TYPE:
850
ADDRESS:9191 COLORADO AVENUETELEPHONE:
(951) 352-2161
CITY:RIVERSIDESTATE: CAZIP CODE:
92503
CAPACITY:73CENSUS: 20DATE:
05/20/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:25 PM
MET WITH:Julie BacaTIME COMPLETED:
03:00 PM
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Due to COVID-19 and the Department of Public Health guidelines, on date and time listed, Licensing Program Analyst (LPA) John Huynh conducted a case management visit by contacting the facility via telephone and spoke with Director, Julie Baca.

LPA Huynh advised the Director that information was received about a possible prior communicable disease outbreak occurring at the facility. LPA explained that additional information was received, and the Department agrees that staff took appropriate steps to prevent the spread. The Department also understands that the incidents happened at different periods of time and could not be considered an outbreak. Based on information gathered, the facility acted appropriately, and no violations have been identified.

An exit interview was conducted, and a copy of this report was provided via email to the facility staff.
A Notice of Site Visit was provided.
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: John HuynhTELEPHONE: (951) 529-2439
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2020
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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