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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334820583
Report Date: 02/07/2024
Date Signed: 02/07/2024 03:46:15 PM


Document Has Been Signed on 02/07/2024 03:46 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501



FACILITY NAME:JURUPA USD SCHOOL READINESS CENTERFACILITY NUMBER:
334820583
ADMINISTRATOR:KATRINA BROOKSFACILITY TYPE:
850
ADDRESS:5960 MUSTANG LANETELEPHONE:
(951) 222-7850
CITY:JURUPA VALLEYSTATE: CAZIP CODE:
92509
CAPACITY:48CENSUS: 10DATE:
02/07/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Katrina Brooks, Program DirectorTIME COMPLETED:
03:55 PM
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On 02/07/2024 Licensing Program Analyst (LPA) Susan Brewer, arrived at the facility for the purpose of conducting a case management visit, in response to the receipt of an unusual incident report (UIR) from the facility. The UIR was received by the licensing agency on 01/29/2024, regarding an incident that was reported to local education agency on 01/18/2024. A census was taken of #10 children in care.

LPA S. Brewer, met with Program Director Katrina Brooks, to discuss the self-reported incident. LPA reviewed and gathered facility records, made observations and conducted interviews with pertinent parties, regarding the incident. Further information will be needed. Upon completion of the review, the outcome and/or recommendations will be provided to the licensee.

No citations were issued during today's inspection.

No civil penalties were issued during today's inspection.

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

An exit interview was conducted and a copy of this report was provided to Program Director Katrina Brooks.
SUPERVISOR'S NAME: Kimberly WilliamsTELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Susan BrewerTELEPHONE: (951) 782-4200
LICENSING EVALUATOR SIGNATURE:
DATE: 02/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/07/2024
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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