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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334830033
Report Date: 05/17/2023
Date Signed: 05/17/2023 10:15:33 AM


Document Has Been Signed on 05/17/2023 10:15 AM - It Cannot Be Edited

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 STREET, STE 700
RIVERSIDE, CA 92501



FACILITY NAME:MAXWELL FAMILY CHILD CAREFACILITY NUMBER:
334830033
ADMINISTRATOR:MAXWELL, MARYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(951) 550-7083
CITY:WINCHESTERSTATE: CAZIP CODE:
92596
CAPACITY:14CENSUS: 9DATE:
05/17/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:35 AM
MET WITH:Mary MaxwellTIME COMPLETED:
10:20 AM
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On May 17, 2023, at 9:35 am, Licensing Program Analyst (LPA) Jessica Rubio arrived at the Maxwell Family Child Care to conduct a licensee initiated case management visit to verify new pool fencing meets Title 22 Regulations. Licensee now has an in ground pool that is not yet completed nor has been filled with water. LPA observed 5' high wrought iron fencing surrounding the front and right side of the pool. The rear and left side of the pool is surrounded by 5'9" wood fencing and a small section on the left has a 6' high wrought iron fence and self-closing, self-latching gate. The 5' high wrought iron fencing has a gate that opens away from the pool, is self-closing and self-latching. Both gates were tested by LPA. The licensee also had the 5' high gate locked at this time with the key located in the nearby kitchen. The fencing meets Title 22 Regulations and the pool is inaccessible. LPA advised licensee to be vigilant of any wear and tear on the fencing, gates, spring and latch and ensure it continues to meet requirements. An exit interview was conducted and provided to Licensee Mary Maxwell. A notice of site visit was also provided and must remain posted for 30 days.
SUPERVISOR'S NAME: Pauline BeschornerTELEPHONE: (951) 255-4093
LICENSING EVALUATOR NAME: Jessica M RubioTELEPHONE: (951) 233-9356
LICENSING EVALUATOR SIGNATURE:
DATE: 05/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/17/2023
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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