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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334830521
Report Date: 08/09/2023
Date Signed: 08/09/2023 01:02:54 PM


Document Has Been Signed on 08/09/2023 01:02 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
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501



FACILITY NAME:FSA-MAGNOLIA CDCFACILITY NUMBER:
334830521
ADMINISTRATOR:LESLIE COXFACILITY TYPE:
850
ADDRESS:8172 MAGNOLIA AVE.TELEPHONE:
(951) 353-0129
CITY:RIVERSIDESTATE: CAZIP CODE:
92504
CAPACITY:156CENSUS: 74DATE:
08/09/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Alondra DominguezTIME COMPLETED:
01:00 PM
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On the date and time listed above, a case management visit is being conducted for a health and wellness check. LPA was granted access to the facility by the Assistant Director, Anadeicy Gonzalez. LPA toured the facility, took census, reviewed records, and conducted interviews. LPA met with the Assistant Director and Director, Alondra Dominguez and discussed care and supervision, personal rights, and staff coverage.

Assistant Director provided LPA with a current personnel report and reported that company has additional staff from sister sites to ensure staff coverage for any site. Both Assistant Director and Director noted no parent concerns at this time and have conducted recent in-services on care and supervision and personal rights for all employees.

LPA conducted three children’s interviews. Interviews disclosed children like playing with toys, outside activity and doing homework. All children interviewed stated they feel safe and that teachers can see them playing.

LPA conducted four staff interviews. Interviews revealed program has a lower census during the summer and that teachers like working for the facility. Additionally, staff stated there are no current parent, employee or children concerns that they are aware of.

LPA made the following observations: Facility is meeting ratio and capacity per CCR Title 22 regulations in all classrooms. Children were engaged in the following activities of indoor free play, transition into lunch, and napping. LPA observed and heard children laughing, asking questions, playing,and transitioning activities. LPA observed direct line of sight for all children by the staff during this visit.

There were no deficiencies cited this visit.

An exit interview was conducted and a copy of this report, Notice of Site visit and appeal rights were provided to the Director, Alondra Dominguez.

SUPERVISOR'S NAME: Gilbert SenaTELEPHONE: (951) 782-4844
LICENSING EVALUATOR NAME: Giselle CarbullidoTELEPHONE: (951) 970-1904
LICENSING EVALUATOR SIGNATURE:
DATE: 08/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/09/2023
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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