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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334840166
Report Date: 03/19/2021
Date Signed: 03/19/2021 01:24:22 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 STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:BARRERA FAMILY CHILD CAREFACILITY NUMBER:
334840166
ADMINISTRATOR:BARRERA, REBECCAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(951) 940-0853
CITY:PERRISSTATE: CAZIP CODE:
92571
CAPACITY:14CENSUS: 6DATE:
03/19/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:20 AM
MET WITH:Rebecca BarreraTIME COMPLETED:
11:50 AM
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Licensing Program Analyst (LPA) James Wilkerson arrived at this facility on 03/18/21 to conduct a case management visit and to deliver an amended report from an original report dated 02/11/21. LPA was granted access into the facility by licensee, Rebecca Barrera toured the facility and conducted census. There were six children present during the visit on 03/18/21. This report is being conducted via FaceTime due to the
COVID-19 pandemic. Acknowledgement of this report via email will be used in lieu of a signature due to the State of Emergency of the pandemic.

There are no deficiencies cited during this visit.

A Notice of Site Visit was posted on 03/18/21, appeal rights discussed and provided along with a copy of this report on 03/18/21 to Ms. Barrera.

A copy of this report must be made available, upon request for three years.
SUPERVISOR'S NAME: Dawn ParkerTELEPHONE: (951) 320-2101
LICENSING EVALUATOR NAME: James WilkersonTELEPHONE: (951) 218-7031
LICENSING EVALUATOR SIGNATURE:

DATE: 03/19/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2021
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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